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 $1,202.26 Median $3,090.30 Typical High $14,454.40 | Facility | None | $1,202.26 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $5,623.41 Typical High $10,232.93 | Professional | None | $1,905.46 | $5,623.41 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
DeanCare Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $2,630.27 | Facility | None | $776.25 | $1,412.54 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $3,019.95 Typical High $7,943.28 | Professional | None | $1,548.82 | $3,019.95 | $7,943.28 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,888.44 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,888.44 | $7,762.47 |
Prevea360 Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $2,630.27 | Facility | None | $776.25 | $1,412.54 | $2,630.27 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $3,162.28 Typical High $4,466.84 | Professional | None | $1,778.28 | $3,162.28 | $4,466.84 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
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 $1,445.44 Median $3,981.07 Typical High $6,606.93 | Professional | None | $1,445.44 | $3,981.07 | $6,606.93 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Where Wisconsin sits
The same service costs 109.6 times more in Alaska 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· 2nd of 51
$5,012
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.