How much rates vary
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 $3,090.30 Typical High $14,454.40 | Facility | None | $1,380.38 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $19,952.62 | Professional | None | $1,380.38 | $1,380.38 | $19,952.62 |
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 $2,884.03 Median $6,606.93 Typical High $9,772.37 | Professional | None | $2,884.03 | $6,606.93 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $7,585.78 | Facility | None | $758.58 | $5,011.87 | $7,585.78 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $1,659.59 Typical High $3,090.30 | Facility | None | $933.25 | $1,659.59 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $8,709.64 | Facility | None | $1,000.00 | $3,801.89 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $5,128.61 Typical High $8,317.64 | Professional | None | $1,819.70 | $5,128.61 | $8,317.64 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,659.59 Typical High $3,090.30 | Facility | None | $933.25 | $1,659.59 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $2,089.30 Median $3,715.35 Typical High $5,128.61 | Professional | None | $2,089.30 | $3,715.35 | $5,128.61 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $7,585.78 | Facility | None | $758.58 | $5,011.87 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $4,677.35 Typical High $7,943.28 | Professional | None | $1,659.59 | $4,677.35 | $7,943.28 |
4 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 $10,000.00 | Professional | 52 · Reduced service | $691.83 | $691.83 | $10,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $3,981.07 | Professional | 53 · Discontinued | $275.42 | $275.42 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $3,019.95 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $3,019.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $1,995.26 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $1,995.26 |
Where Wisconsin sits
The same service costs 147.9 times more in Alaska 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· 2nd of 51
$5,370
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.