How much rates vary
Facilitymedian $1,585 · 10th to 90th $191 to $4,365Professionalmedian $224 · 10th to 90th $74 to $646
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 $47.86 Median $131.83 Typical High $14,454.40 | Facility | None | $47.86 | $131.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $131.83 Typical High $1,000.00 | Professional | None | $47.86 | $131.83 | $1,000.00 |
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 $107.15 Median $251.19 Typical High $660.69 | Professional | None | $107.15 | $251.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $416.87 Typical High $1,071.52 | Facility | None | $190.55 | $416.87 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $169.82 Typical High $467.74 | Professional | None | $63.10 | $169.82 | $467.74 |
DeanCare Setting Facility Modifier None Typical Low $66.07 Median $2,630.27 Typical High $5,128.61 | Facility | None | $66.07 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $97.72 Median $199.53 Typical High $407.38 | Professional | None | $97.72 | $199.53 | $407.38 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $1,412.54 Typical High $3,019.95 | Facility | None | $169.82 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $478.63 Typical High $645.65 | Professional | None | $154.88 | $478.63 | $645.65 |
Network Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,122.02 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $436.52 | Professional | None | $79.43 | $218.78 | $436.52 |
Prevea360 Setting Facility Modifier None Typical Low $51.29 Median $123.03 Typical High $288.40 | Facility | None | $51.29 | $123.03 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $75.86 Median $239.88 Typical High $501.19 | Professional | None | $75.86 | $239.88 | $501.19 |
Quartz Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $1,479.11 | Facility | None | $186.21 | $288.40 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $245.47 | Professional | None | $63.10 | $151.36 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $295.12 | Professional | None | $104.71 | $104.71 | $295.12 |
Security Health Setting Professional Modifier None Typical Low $125.89 Median $288.40 Typical High $776.25 | Professional | None | $125.89 | $288.40 | $776.25 |
The Alliance Setting Professional Modifier None Typical Low $281.84 Median $549.54 Typical High $1,000.00 | Professional | None | $281.84 | $549.54 | $1,000.00 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $70.79 Median $208.93 Typical High $588.84 | Professional | None | $70.79 | $208.93 | $588.84 |
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 $23.99 Median $23.99 Typical High $66.07 | Facility | 52 · Reduced service | $23.99 | $23.99 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $26.30 | Facility | 53 · Discontinued | $9.55 | $9.55 | $26.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $97.72 | Facility | 54 · Surgery only | $35.48 | $35.48 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $19.50 | Facility | 55 · Aftercare only | $7.08 | $7.08 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $13.18 | Facility | 56 · Pre-op care only | $4.79 | $4.79 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $66.07 Typical High $549.54 | Professional | 52 · Reduced service | $23.99 | $66.07 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $26.30 Typical High $218.78 | Professional | 53 · Discontinued | $9.55 | $26.30 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $97.72 Typical High $831.76 | Professional | 54 · Surgery only | $35.48 | $97.72 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $19.50 Typical High $165.96 | Professional | 55 · Aftercare only | $7.08 | $19.50 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $13.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $4.79 | $13.18 | $109.65 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $100.00 Typical High $204.17 | Professional | 51 · Multiple procedures | $48.98 | $100.00 | $204.17 |
Where Wisconsin sits
The same service costs 2.6 times more in Alaska than in Montana. 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
$275
AK $282MT $107
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.