How much rates vary
Facilitymedian $1,380 · 10th to 90th $50 to $3,890Professionalmedian $85 · 10th to 90th $32 to $186
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 $21.88 Median $41.69 Typical High $14,454.40 | Facility | None | $21.88 | $41.69 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $41.69 Typical High $125.89 | Professional | None | $21.88 | $41.69 | $125.89 |
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 $44.67 Median $95.50 Typical High $199.53 | Professional | None | $44.67 | $95.50 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $56.23 | Professional | None | $41.69 | $44.67 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $120.23 Typical High $186.21 | Facility | None | $50.12 | $120.23 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $51.29 Typical High $134.90 | Professional | None | $26.92 | $51.29 | $134.90 |
DeanCare Setting Facility Modifier None Typical Low $28.18 Median $2,630.27 Typical High $5,128.61 | Facility | None | $28.18 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $120.23 | Professional | None | $41.69 | $79.43 | $120.23 |
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 $46.77 Median $147.91 Typical High $338.84 | Professional | None | $46.77 | $147.91 | $338.84 |
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 $54.95 Median $74.13 Typical High $125.89 | Professional | None | $54.95 | $74.13 | $125.89 |
Prevea360 Setting Facility Modifier None Typical Low $21.88 Median $45.71 Typical High $87.10 | Facility | None | $21.88 | $45.71 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $147.91 | Professional | None | $45.71 | $77.62 | $147.91 |
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 $26.92 Median $43.65 Typical High $72.44 | Professional | None | $26.92 | $43.65 | $72.44 |
Security Health Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $83.18 | Professional | None | $44.67 | $44.67 | $83.18 |
Security Health Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $213.80 | Professional | None | $57.54 | $117.49 | $213.80 |
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 $29.51 Median $81.28 Typical High $177.83 | Professional | None | $29.51 | $81.28 | $177.83 |
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 $10.96 Median $10.96 Typical High $20.89 | Facility | 52 · Reduced service | $10.96 | $10.96 | $20.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $8.32 | Facility | 53 · Discontinued | $4.37 | $4.37 | $8.32 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $16.22 Median $16.22 Typical High $30.90 | Facility | 54 · Surgery only | $16.22 | $16.22 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $6.17 | Facility | 55 · Aftercare only | $3.24 | $3.24 | $6.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $4.17 | Facility | 56 · Pre-op care only | $2.19 | $2.19 | $4.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $20.89 Typical High $109.65 | Professional | 52 · Reduced service | $10.96 | $20.89 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $8.32 Typical High $44.67 | Professional | 53 · Discontinued | $4.37 | $8.32 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $30.90 Typical High $165.96 | Professional | 54 · Surgery only | $16.22 | $30.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $6.17 Typical High $33.11 | Professional | 55 · Aftercare only | $3.24 | $6.17 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $4.17 Typical High $21.88 | Professional | 56 · Pre-op care only | $2.19 | $4.17 | $21.88 |
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
$102
AK $120NJ $34.67
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.