How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,445 to $11,482Professionalmedian $5,623 · 10th to 90th $1,622 to $13,490
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 $1,445.44 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,445.44 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $1,819.70 Median $6,918.31 Typical High $13,803.84 | Professional | None | $1,819.70 | $6,918.31 | $13,803.84 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $6,025.60 | Facility | None | $758.58 | $3,630.78 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $3,801.89 | Professional | None | $2,754.23 | $3,311.31 | $3,801.89 |
DeanCare Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $14,791.08 | Facility | None | $1,737.80 | $7,943.28 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $5,623.41 Typical High $12,022.64 | Facility | None | $1,202.26 | $5,623.41 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $2,398.83 Median $6,456.54 Typical High $10,232.93 | Professional | None | $2,398.83 | $6,456.54 | $10,232.93 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $3,162.28 | Facility | None | $851.14 | $1,737.80 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,801.89 | $5,248.07 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $6,025.60 | Facility | None | $758.58 | $3,630.78 | $6,025.60 |
Quartz Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $6,606.93 | Professional | None | $2,691.53 | $2,691.53 | $6,606.93 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $6,606.93 Typical High $10,471.29 | Professional | None | $2,137.96 | $6,606.93 | $10,471.29 |
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 $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Where Wisconsin sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 1st of 51
$6,026
WI $6,026NE $380
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.