How much rates vary
Facilitymedian $1,380 · 10th to 90th $50 to $3,890Professionalmedian $54 · 10th to 90th $19 to $132
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 $12.88 Median $30.20 Typical High $14,454.40 | Facility | None | $12.88 | $30.20 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $72.44 | Professional | None | $12.88 | $30.20 | $72.44 |
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 $27.54 Median $63.10 Typical High $138.04 | Professional | None | $27.54 | $63.10 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $40.74 | Professional | None | $30.20 | $33.11 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $138.04 | Facility | None | $50.12 | $89.13 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $38.02 Typical High $100.00 | Professional | None | $16.22 | $38.02 | $100.00 |
DeanCare Setting Facility Modifier None Typical Low $16.98 Median $2,630.27 Typical High $5,128.61 | Facility | None | $16.98 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $25.12 Median $47.86 Typical High $89.13 | Professional | None | $25.12 | $47.86 | $89.13 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $912.01 Typical High $1,778.28 | Facility | None | $54.95 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $245.47 | Professional | None | $33.11 | $107.15 | $245.47 |
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 $33.88 Median $45.71 Typical High $91.20 | Professional | None | $33.88 | $45.71 | $91.20 |
Prevea360 Setting Facility Modifier None Typical Low $13.18 Median $29.51 Typical High $63.10 | Facility | None | $13.18 | $29.51 | $63.10 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $53.70 Typical High $107.15 | Professional | None | $27.54 | $53.70 | $107.15 |
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 $16.22 Median $30.90 Typical High $52.48 | Professional | None | $16.22 | $30.90 | $52.48 |
Security Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $60.26 | Professional | None | $26.92 | $26.92 | $60.26 |
Security Health Setting Professional Modifier None Typical Low $34.67 Median $69.18 Typical High $158.49 | Professional | None | $34.67 | $69.18 | $158.49 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,148.15 Typical High $1,862.09 | Facility | None | $204.17 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $17.38 Median $50.12 Typical High $128.82 | Professional | None | $17.38 | $50.12 | $128.82 |
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 $6.46 Median $6.46 Typical High $15.14 | Facility | 52 · Reduced service | $6.46 | $6.46 | $15.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $6.03 | Facility | 53 · Discontinued | $2.57 | $2.57 | $6.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $9.77 Median $9.77 Typical High $22.39 | Facility | 54 · Surgery only | $9.77 | $9.77 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $4.57 | Facility | 55 · Aftercare only | $1.95 | $1.95 | $4.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $3.02 | Facility | 56 · Pre-op care only | $1.29 | $1.29 | $3.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $15.14 Typical High $63.10 | Professional | 52 · Reduced service | $6.46 | $15.14 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $6.03 Typical High $25.12 | Professional | 53 · Discontinued | $2.57 | $6.03 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $22.39 Typical High $95.50 | Professional | 54 · Surgery only | $9.77 | $22.39 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $4.57 Typical High $19.05 | Professional | 55 · Aftercare only | $1.95 | $4.57 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $3.02 Typical High $12.59 | Professional | 56 · Pre-op care only | $1.29 | $3.02 | $12.59 |
Where Wisconsin sits
The same service costs 3.5 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
$64.57
AK $83.18NJ $23.99
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.