How much rates vary
Facilitymedian $1,380 · 10th to 90th $71 to $3,890Professionalmedian $93 · 10th to 90th $32 to $316
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 $19.05 Median $70.79 Typical High $14,454.40 | Facility | None | $19.05 | $70.79 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $69.18 Typical High $181.97 | Professional | None | $19.05 | $69.18 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $109.65 Typical High $323.59 | Professional | None | $45.71 | $109.65 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $100.00 | Professional | None | $75.86 | $81.28 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $223.87 Typical High $338.84 | Facility | None | $50.12 | $223.87 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $75.86 Typical High $251.19 | Professional | None | $25.12 | $75.86 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $26.30 Median $2,630.27 Typical High $5,128.61 | Facility | None | $26.30 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $204.17 | Professional | None | $38.90 | $74.13 | $204.17 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $912.01 Typical High $1,778.28 | Facility | None | $91.20 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $199.53 Typical High $616.60 | Professional | None | $64.57 | $199.53 | $616.60 |
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 $52.48 Median $112.20 Typical High $181.97 | Professional | None | $52.48 | $112.20 | $181.97 |
Prevea360 Setting Facility Modifier None Typical Low $20.42 Median $45.71 Typical High $125.89 | Facility | None | $20.42 | $45.71 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $42.66 Median $93.33 Typical High $269.15 | Professional | None | $42.66 | $93.33 | $269.15 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $25.12 Median $61.66 Typical High $131.83 | Professional | None | $25.12 | $61.66 | $131.83 |
Security Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $158.49 | Professional | None | $41.69 | $41.69 | $158.49 |
Security Health Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $389.05 | Professional | None | $53.70 | $114.82 | $389.05 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $27.54 Median $85.11 Typical High $269.15 | Professional | None | $27.54 | $85.11 | $269.15 |
11 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 $9.33 Median $9.33 Typical High $34.67 | Facility | 52 · Reduced service | $9.33 | $9.33 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $14.13 | Facility | 53 · Discontinued | $3.80 | $3.80 | $14.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $14.13 Median $14.13 Typical High $52.48 | Facility | 54 · Surgery only | $14.13 | $14.13 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $10.47 | Facility | 55 · Aftercare only | $2.82 | $2.82 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $7.08 | Facility | 56 · Pre-op care only | $1.91 | $1.91 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $34.67 Typical High $102.33 | Professional | 52 · Reduced service | $9.33 | $34.67 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $14.13 Typical High $41.69 | Professional | 53 · Discontinued | $3.80 | $14.13 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $52.48 Typical High $154.88 | Professional | 54 · Surgery only | $14.13 | $52.48 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $10.47 Typical High $30.90 | Professional | 55 · Aftercare only | $2.82 | $10.47 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $7.08 Typical High $20.89 | Professional | 56 · Pre-op care only | $1.91 | $7.08 | $20.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $19.50 Median $37.15 Typical High $102.33 | Professional | 51 · Multiple procedures | $19.50 | $37.15 | $102.33 |
Where Wisconsin sits
The same service costs 3.4 times more in Wisconsin 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· 1st of 51
$123
WI $123KY $36.31
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.