How much rates vary
Facilitymedian $1,000 · 10th to 90th $105 to $3,162Professionalmedian $234 · 10th to 90th $98 to $501
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 $58.88 Median $97.72 Typical High $14,454.40 | Facility | None | $58.88 | $97.72 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $602.56 | Professional | None | $58.88 | $97.72 | $602.56 |
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 $117.49 Median $275.42 Typical High $512.86 | Professional | None | $117.49 | $275.42 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $1,096.48 | Facility | None | $302.00 | $354.81 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $190.55 Typical High $346.74 | Professional | None | $93.33 | $190.55 | $346.74 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $4,265.80 Typical High $7,762.47 | Facility | None | $81.28 | $4,265.80 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $302.00 | Professional | None | $123.03 | $199.53 | $302.00 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $912.01 Typical High $1,778.28 | Facility | None | $134.90 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $389.05 Typical High $851.14 | Professional | None | $123.03 | $389.05 | $851.14 |
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 $158.49 Median $213.80 Typical High $323.59 | Professional | None | $158.49 | $213.80 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $107.15 Typical High $234.42 | Facility | None | $64.57 | $107.15 | $234.42 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $398.11 | Professional | None | $128.82 | $218.78 | $398.11 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $812.83 Typical High $2,691.53 | Facility | None | $537.03 | $812.83 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $218.78 | Professional | None | $93.33 | $144.54 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $575.44 | Professional | None | $169.82 | $338.84 | $575.44 |
The Alliance Setting Professional Modifier None Typical Low $218.78 Median $426.58 Typical High $707.95 | Professional | None | $218.78 | $426.58 | $707.95 |
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 $83.18 Median $223.87 Typical High $467.74 | Professional | None | $83.18 | $223.87 | $467.74 |
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 $29.51 Median $29.51 Typical High $48.98 | Facility | 52 · Reduced service | $29.51 | $29.51 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $19.50 | Facility | 53 · Discontinued | $12.02 | $12.02 | $19.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $74.13 | Facility | 54 · Surgery only | $44.67 | $44.67 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $14.79 | Facility | 55 · Aftercare only | $8.91 | $8.91 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $9.77 | Facility | 56 · Pre-op care only | $5.89 | $5.89 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $48.98 Typical High $549.54 | Professional | 52 · Reduced service | $29.51 | $48.98 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $19.50 Typical High $218.78 | Professional | 53 · Discontinued | $12.02 | $19.50 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $74.13 Typical High $812.83 | Professional | 54 · Surgery only | $44.67 | $74.13 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $14.79 Typical High $162.18 | Professional | 55 · Aftercare only | $8.91 | $14.79 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.77 Typical High $109.65 | Professional | 56 · Pre-op care only | $5.89 | $9.77 | $109.65 |
Where Wisconsin sits
The same service costs 14.9 times more in New York 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.
Physician feeFacility fee
NY $3,056KY $205
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.