How much rates vary
Facilitymedian $12,023 · 10th to 90th $813 to $22,387Professionalmedian $5,888 · 10th to 90th $1,738 to $10,715
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 $1,380.38 Median $1,380.38 Typical High $14,454.40 | Facility | None | $1,380.38 | $1,380.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $5,888.44 | Professional | None | $1,380.38 | $1,380.38 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $17,782.79 Typical High $29,512.09 | Facility | None | $12,022.64 | $17,782.79 | $29,512.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $6,760.83 Typical High $11,220.18 | Professional | None | $2,754.23 | $6,760.83 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,630.78 | Facility | None | $645.65 | $1,071.52 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,388.44 | $3,890.45 | $3,890.45 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,019.95 | Facility | None | $1,000.00 | $1,659.59 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,570.40 Typical High $18,197.01 | Facility | None | $501.19 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $6,760.83 Typical High $11,220.18 | Professional | None | $2,454.71 | $6,760.83 | $11,220.18 |
Prevea360 Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,019.95 | Facility | None | $1,000.00 | $1,659.59 | $3,019.95 |
Quartz Setting Professional Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $4,897.79 | Professional | None | $1,737.80 | $3,630.78 | $4,897.79 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,630.78 | Facility | None | $645.65 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $6,025.60 | Professional | None | $4,570.88 | $4,570.88 | $6,025.60 |
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 $2,089.30 Median $6,918.31 Typical High $10,715.19 | Professional | None | $2,089.30 | $6,918.31 | $10,715.19 |
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 $691.83 Median $691.83 Typical High $2,951.21 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,174.90 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $870.96 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $588.84 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $588.84 |
Where Wisconsin sits
The same service costs 5.8 times more in California than in Arkansas. 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
$6,607
CA $6,918AR $1,202
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.