How much rates vary
Facilitymedian $15,136 · 10th to 90th $1,349 to $28,184Professionalmedian $1,905 · 10th to 90th $525 to $3,715
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 $380.19 Median $380.19 Typical High $14,454.40 | Facility | None | $380.19 | $380.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $17,782.79 Typical High $26,302.68 | Facility | None | $12,022.64 | $17,782.79 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $2,089.30 Typical High $4,073.80 | Professional | None | $575.44 | $2,089.30 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $25,118.86 Typical High $40,738.03 | Facility | None | $758.58 | $25,118.86 | $40,738.03 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,995.26 | Professional | None | $812.83 | $812.83 | $1,995.26 |
DeanCare Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $851.14 | Facility | None | $257.04 | $457.09 | $851.14 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $9,120.11 Typical High $19,952.62 | Facility | None | $1,348.96 | $9,120.11 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $2,089.30 Typical High $3,311.31 | Professional | None | $776.25 | $2,089.30 | $3,311.31 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $13,489.63 Typical High $27,542.29 | Facility | None | $3,388.44 | $13,489.63 | $27,542.29 |
Prevea360 Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $851.14 | Facility | None | $257.04 | $457.09 | $851.14 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $1,096.48 Typical High $1,513.56 | Professional | None | $575.44 | $1,096.48 | $1,513.56 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $25,118.86 Typical High $40,738.03 | Facility | None | $758.58 | $25,118.86 | $40,738.03 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,995.26 | Professional | None | $812.83 | $812.83 | $1,995.26 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $645.65 Median $2,137.96 Typical High $3,311.31 | Professional | None | $645.65 | $2,137.96 | $3,311.31 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Where Wisconsin sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 14th of 51
$2,951
OK $14,454NY $525
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.