How much rates vary
Facilitymedian $2,512 · 10th to 90th $174 to $5,754Professionalmedian $309 · 10th to 90th $129 to $676
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 $79.43 Median $134.90 Typical High $14,454.40 | Facility | None | $79.43 | $134.90 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $1,000.00 | Professional | None | $79.43 | $134.90 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $363.08 Typical High $707.95 | Professional | None | $151.36 | $363.08 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $199.53 | Professional | None | $147.91 | $158.49 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $426.58 Typical High $870.96 | Facility | None | $158.49 | $426.58 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $478.63 | Professional | None | $107.15 | $190.55 | $478.63 |
DeanCare Setting Facility Modifier None Typical Low $109.65 Median $3,162.28 Typical High $5,888.44 | Facility | None | $109.65 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $426.58 | Professional | None | $162.18 | $281.84 | $426.58 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $2,187.76 Typical High $4,677.35 | Facility | None | $190.55 | $2,187.76 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $478.63 Typical High $3,162.28 | Professional | None | $165.96 | $478.63 | $3,162.28 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $426.58 | Professional | None | $208.93 | $288.40 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $302.00 | Facility | None | $85.11 | $147.91 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $524.81 | Professional | None | $177.83 | $309.03 | $524.81 |
Quartz Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $1,479.11 | Facility | None | $154.88 | $239.88 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $263.03 | Professional | None | $107.15 | $169.82 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $302.00 | Professional | None | $173.78 | $173.78 | $302.00 |
Security Health Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $776.25 | Professional | None | $223.87 | $446.68 | $776.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,677.35 | Facility | None | $707.95 | $2,754.23 | $4,677.35 |
United Setting Professional Modifier None Typical Low $114.82 Median $302.00 Typical High $588.84 | Professional | None | $114.82 | $302.00 | $588.84 |
11 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 $39.81 Median $39.81 Typical High $67.61 | Facility | 52 · Reduced service | $39.81 | $39.81 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $26.92 | Facility | 53 · Discontinued | $15.85 | $15.85 | $26.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $102.33 | Facility | 54 · Surgery only | $60.26 | $60.26 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $20.42 | Facility | 55 · Aftercare only | $12.02 | $12.02 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $13.49 | Facility | 56 · Pre-op care only | $7.94 | $7.94 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $67.61 Typical High $575.44 | Professional | 52 · Reduced service | $39.81 | $67.61 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $26.92 Typical High $229.09 | Professional | 53 · Discontinued | $15.85 | $26.92 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $102.33 Typical High $851.14 | Professional | 54 · Surgery only | $60.26 | $102.33 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.42 Typical High $169.82 | Professional | 55 · Aftercare only | $12.02 | $20.42 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $13.49 Typical High $114.82 | Professional | 56 · Pre-op care only | $7.94 | $13.49 | $114.82 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $141.25 Typical High $213.80 | Professional | 51 · Multiple procedures | $81.28 | $141.25 | $213.80 |
Where Wisconsin sits
The same service costs 3.2 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
$372
AK $407NJ $129
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.