How much rates vary
Facilitymedian $955 · 10th to 90th $151 to $2,692Professionalmedian $355 · 10th to 90th $129 to $1,096
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 $60.26 Median $199.53 Typical High $14,454.40 | Facility | None | $60.26 | $199.53 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $199.53 Typical High $1,230.27 | Professional | None | $60.26 | $199.53 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $1,071.52 | Professional | None | $162.18 | $354.81 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $741.31 Typical High $1,318.26 | Facility | None | $630.96 | $741.31 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $331.13 Typical High $707.95 | Professional | None | $131.83 | $331.13 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $83.18 Median $3,162.28 Typical High $5,888.44 | Facility | None | $83.18 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $912.01 | Professional | None | $151.36 | $275.42 | $912.01 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $1,778.28 | Facility | None | $154.88 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $776.25 Typical High $1,202.26 | Professional | None | $302.00 | $776.25 | $1,202.26 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $831.76 | Professional | None | $204.17 | $371.54 | $831.76 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $169.82 Typical High $489.78 | Facility | None | $64.57 | $169.82 | $489.78 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $302.00 Typical High $812.83 | Professional | None | $87.10 | $302.00 | $812.83 |
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 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $380.19 Typical High $676.08 | Professional | None | $131.83 | $380.19 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $446.68 | Professional | None | $131.83 | $131.83 | $446.68 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $1,318.26 | Professional | None | $263.03 | $478.63 | $1,318.26 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $104.71 Median $323.59 Typical High $1,096.48 | Professional | None | $104.71 | $323.59 | $1,096.48 |
10 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 Facility Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $100.00 | Facility | 52 · Reduced service | $30.20 | $30.20 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $39.81 | Facility | 53 · Discontinued | $12.02 | $12.02 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $151.36 | Facility | 54 · Surgery only | $44.67 | $44.67 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $30.20 | Facility | 55 · Aftercare only | $8.91 | $8.91 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $19.95 | Facility | 56 · Pre-op care only | $6.03 | $6.03 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $100.00 Typical High $616.60 | Professional | 52 · Reduced service | $30.20 | $100.00 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $39.81 Typical High $245.47 | Professional | 53 · Discontinued | $12.02 | $39.81 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $151.36 Typical High $933.25 | Professional | 54 · Surgery only | $44.67 | $151.36 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $30.20 Typical High $186.21 | Professional | 55 · Aftercare only | $8.91 | $30.20 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $19.95 Typical High $123.03 | Professional | 56 · Pre-op care only | $6.03 | $19.95 | $123.03 |
Where Wisconsin sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 4th of 51
$389
OK $575NE $129
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.