How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $11,220Professionalmedian $1,950 · 10th to 90th $513 to $3,467
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 $302.00 Median $6,456.54 Typical High $14,454.40 | Facility | None | $302.00 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $676.08 Median $2,089.30 Typical High $3,890.45 | Professional | None | $676.08 | $2,089.30 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $5,754.40 | Facility | None | $758.58 | $3,467.37 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,949.84 | Professional | None | $758.58 | $758.58 | $1,949.84 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $660.69 | Facility | None | $204.17 | $363.08 | $660.69 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $10,964.78 | Facility | None | $912.01 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,949.84 Typical High $3,235.94 | Professional | None | $724.44 | $1,949.84 | $3,235.94 |
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 $204.17 Median $363.08 Typical High $660.69 | Facility | None | $204.17 | $363.08 | $660.69 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $1,258.93 | Professional | None | $446.68 | $851.14 | $1,258.93 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $5,754.40 | Facility | None | $758.58 | $3,467.37 | $5,754.40 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,949.84 | Professional | None | $758.58 | $758.58 | $1,949.84 |
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 $501.19 Median $1,995.26 Typical High $3,090.30 | Professional | None | $501.19 | $1,995.26 | $3,090.30 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Where Wisconsin sits
The same service costs 10.2 times more in Texas 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· 3rd of 51
$2,455
TX $2,692NY $263
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.