How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $11,220Professionalmedian $1,072 · 10th to 90th $380 to $2,570
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 $3,090.30 Typical High $14,454.40 | Facility | None | $380.19 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $3,715.35 | Professional | None | $380.19 | $380.19 | $3,715.35 |
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 $346.74 Median $1,318.26 Typical High $2,570.40 | Professional | None | $346.74 | $1,318.26 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $1,949.84 Typical High $3,801.89 | Professional | 50 · Both sides | $524.81 | $1,949.84 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,365.16 Typical High $6,918.31 | Facility | None | $758.58 | $4,365.16 | $6,918.31 |
DeanCare Setting Facility Modifier None Typical Low $213.80 Median $457.09 Typical High $831.76 | Facility | None | $213.80 | $457.09 | $831.76 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $12,302.69 | Facility | None | $912.01 | $5,623.41 | $12,302.69 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $2,570.40 | Professional | None | $416.87 | $794.33 | $2,570.40 |
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 $213.80 Median $457.09 Typical High $831.76 | Facility | None | $213.80 | $457.09 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,348.96 | Professional | None | $562.34 | $954.99 | $1,348.96 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $4,365.16 Typical High $6,918.31 | Facility | None | $758.58 | $4,365.16 | $6,918.31 |
The Alliance Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $4,786.30 | Professional | None | $707.95 | $707.95 | $4,786.30 |
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 $398.11 Median $741.31 Typical High $1,778.28 | Professional | None | $398.11 | $741.31 | $1,778.28 |
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 $1,862.09 | Professional | 52 · Reduced service | $190.55 | $190.55 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $741.31 | Professional | 53 · Discontinued | $75.86 | $75.86 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $2,818.38 | Professional | 54 · Surgery only | $281.84 | $281.84 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $562.34 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $371.54 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $371.54 |
Where Wisconsin sits
The same service costs 28.2 times more in Texas than in Kentucky. 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
$1,380
TX $2,570KY $91.20
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.