How much rates vary
Facilitymedian $5,623 · 10th to 90th $603 to $16,218Professionalmedian $1,047 · 10th to 90th $309 to $2,042
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $14,454.40 | Facility | None | $288.40 | $288.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $1,258.93 Typical High $2,187.76 | Professional | None | $389.05 | $1,258.93 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $29,512.09 | Facility | None | $29,512.09 | $29,512.09 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,096.48 | Professional | None | $446.68 | $1,096.48 | $1,096.48 |
DeanCare Setting Facility Modifier None Typical Low $194.98 Median $346.74 Typical High $630.96 | Facility | None | $194.98 | $346.74 | $630.96 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $2,454.71 Typical High $18,197.01 | Facility | None | $407.38 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,047.13 Typical High $1,862.09 | Professional | None | $371.54 | $1,047.13 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $194.98 Median $346.74 Typical High $630.96 | Facility | None | $194.98 | $346.74 | $630.96 |
Quartz Setting Professional Modifier None Typical Low $354.81 Median $741.31 Typical High $1,023.29 | Professional | None | $354.81 | $741.31 | $1,023.29 |
Quartz Setting Facility Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $29,512.09 | Facility | None | $29,512.09 | $29,512.09 | $29,512.09 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $1,096.48 | Professional | None | $446.68 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,000.00 Typical High $1,513.56 | Professional | None | $338.84 | $1,000.00 | $1,513.56 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Where Wisconsin sits
The same service costs 6.3 times more in Texas than in Pennsylvania. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 3rd of 51
$1,318
TX $1,995PA $316
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.