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 $1,905.46 Median $2,454.71 Typical High $14,454.40 | Facility | None | $1,905.46 | $2,454.71 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,365.16 Median $12,022.64 Typical High $23,988.33 | Professional | None | $4,365.16 | $12,022.64 | $23,988.33 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,290.87 | Facility | None | $758.58 | $1,380.38 | $2,290.87 |
DeanCare Setting Facility Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $5,370.32 | Facility | None | $2,238.72 | $2,951.21 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $6,309.57 | Facility | None | $707.95 | $2,818.38 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $4,073.80 Median $10,715.19 Typical High $19,498.45 | Professional | None | $4,073.80 | $10,715.19 | $19,498.45 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $5,495.41 | Facility | None | $1,862.09 | $2,951.21 | $5,495.41 |
Quartz Setting Professional Modifier None Typical Low $3,467.37 Median $6,309.57 Typical High $9,332.54 | Professional | None | $3,467.37 | $6,309.57 | $9,332.54 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,290.87 | Facility | None | $758.58 | $1,380.38 | $2,290.87 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $8,912.51 Typical High $16,218.10 | Professional | None | $3,548.13 | $8,912.51 | $16,218.10 |
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 $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $676.08 | Professional | 53 · Discontinued | $501.19 | $501.19 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $338.84 |
Where Wisconsin sits
The same service costs 3.5 times more in Indiana than in Maryland. 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.