How much rates vary
Facilitymedian $1,000 · 10th to 90th $20 to $2,455Professionalmedian $49 · 10th to 90th $18 to $81
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 $13.49 Median $15.49 Typical High $14,454.40 | Facility | None | $13.49 | $15.49 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $15.49 Typical High $154.88 | Professional | None | $13.49 | $15.49 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.44 Median $54.95 Typical High $83.18 | Professional | None | $23.44 | $54.95 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $54.95 Typical High $91.20 | Facility | None | $48.98 | $54.95 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $60.26 | Professional | None | $17.78 | $26.92 | $60.26 |
DeanCare Setting Facility Modifier None Typical Low $17.38 Median $2,570.40 Typical High $4,786.30 | Facility | None | $17.38 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $28.18 Median $32.36 Typical High $50.12 | Professional | None | $28.18 | $32.36 | $50.12 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $912.01 Typical High $1,778.28 | Facility | None | $32.36 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $51.29 Typical High $199.53 | Professional | None | $19.50 | $51.29 | $199.53 |
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 $25.12 Median $41.69 Typical High $53.70 | Professional | None | $25.12 | $41.69 | $53.70 |
Prevea360 Setting Facility Modifier None Typical Low $14.79 Median $21.38 Typical High $38.02 | Facility | None | $14.79 | $21.38 | $38.02 |
Quartz Setting Professional Modifier None Typical Low $22.91 Median $41.69 Typical High $69.18 | Professional | None | $22.91 | $41.69 | $69.18 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $2,691.53 | Facility | None | $50.12 | $50.12 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $45.71 | Professional | None | $17.78 | $20.89 | $45.71 |
Security Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | None | $30.20 | $30.20 | $33.88 |
Security Health Setting Professional Modifier None Typical Low $33.88 Median $72.44 Typical High $89.13 | Professional | None | $33.88 | $72.44 | $89.13 |
The Alliance Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $123.03 | Professional | None | $33.88 | $67.61 | $123.03 |
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 $17.78 Median $40.74 Typical High $74.13 | Professional | None | $17.78 | $40.74 | $74.13 |
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 $6.76 Median $6.76 Typical High $7.76 | Facility | 52 · Reduced service | $6.76 | $6.76 | $7.76 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $3.16 | Facility | 53 · Discontinued | $2.75 | $2.75 | $3.16 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $10.23 Median $10.23 Typical High $11.75 | Facility | 54 · Surgery only | $10.23 | $10.23 | $11.75 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.34 | Facility | 55 · Aftercare only | $2.04 | $2.04 | $2.34 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.55 | Facility | 56 · Pre-op care only | $1.35 | $1.35 | $1.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $7.76 Typical High $77.62 | Professional | 52 · Reduced service | $6.76 | $7.76 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.16 Typical High $30.90 | Professional | 53 · Discontinued | $2.75 | $3.16 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $11.75 Typical High $117.49 | Professional | 54 · Surgery only | $10.23 | $11.75 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.34 Typical High $23.44 | Professional | 55 · Aftercare only | $2.04 | $2.34 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.55 Typical High $15.49 | Professional | 56 · Pre-op care only | $1.35 | $1.55 | $15.49 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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
$51.29
AK $64.57NJ $16.60
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.