How much rates vary
Facilitymedian $933 · 10th to 90th $60 to $2,344Professionalmedian $115 · 10th to 90th $41 to $302
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 $25.70 Median $60.26 Typical High $14,454.40 | Facility | None | $25.70 | $60.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $60.26 Typical High $602.56 | Professional | None | $25.70 | $60.26 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $134.90 Typical High $302.00 | Professional | None | $58.88 | $134.90 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $218.78 Typical High $1,288.25 | Facility | None | $190.55 | $218.78 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $79.43 Typical High $213.80 | Professional | None | $34.67 | $79.43 | $213.80 |
DeanCare Setting Facility Modifier None Typical Low $35.48 Median $2,630.27 Typical High $5,128.61 | Facility | None | $35.48 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $52.48 Median $107.15 Typical High $186.21 | Professional | None | $52.48 | $107.15 | $186.21 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $912.01 Typical High $1,778.28 | Facility | None | $77.62 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $229.09 Typical High $309.03 | Professional | None | $74.13 | $229.09 | $309.03 |
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 $42.66 Median $102.33 Typical High $199.53 | Professional | None | $42.66 | $102.33 | $199.53 |
Prevea360 Setting Facility Modifier None Typical Low $27.54 Median $61.66 Typical High $138.04 | Facility | None | $27.54 | $61.66 | $138.04 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $100.00 Typical High $234.42 | Professional | None | $39.81 | $100.00 | $234.42 |
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 $34.67 Median $72.44 Typical High $112.20 | Professional | None | $34.67 | $72.44 | $112.20 |
Security Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $134.90 | Professional | None | $57.54 | $57.54 | $134.90 |
Security Health Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $354.81 | Professional | None | $67.61 | $151.36 | $354.81 |
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 $38.02 Median $109.65 Typical High $281.84 | Professional | None | $38.02 | $109.65 | $281.84 |
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 $12.88 Median $12.88 Typical High $30.20 | Facility | 52 · Reduced service | $12.88 | $12.88 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $12.02 | Facility | 53 · Discontinued | $5.13 | $5.13 | $12.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $44.67 | Facility | 54 · Surgery only | $19.50 | $19.50 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $8.91 | Facility | 55 · Aftercare only | $3.89 | $3.89 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $6.03 | Facility | 56 · Pre-op care only | $2.57 | $2.57 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $30.20 Typical High $302.00 | Professional | 52 · Reduced service | $12.88 | $30.20 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $12.02 Typical High $120.23 | Professional | 53 · Discontinued | $5.13 | $12.02 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $44.67 Typical High $457.09 | Professional | 54 · Surgery only | $19.50 | $44.67 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $8.91 Typical High $91.20 | Professional | 55 · Aftercare only | $3.89 | $8.91 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $6.03 Typical High $60.26 | Professional | 56 · Pre-op care only | $2.57 | $6.03 | $60.26 |
Where Wisconsin sits
The same service costs 3.3 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
$129
AK $155KY $46.77
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.