How much rates vary
Facilitymedian $1,000 · 10th to 90th $35 to $2,399Professionalmedian $78 · 10th to 90th $28 to $145
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 $20.89 Median $27.54 Typical High $14,454.40 | Facility | None | $20.89 | $27.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $363.08 | Professional | None | $20.89 | $27.54 | $363.08 |
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 $36.31 Median $93.33 Typical High $144.54 | Professional | None | $36.31 | $93.33 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $100.00 Typical High $1,479.11 | Facility | None | $85.11 | $100.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $95.50 | Professional | None | $27.54 | $41.69 | $95.50 |
DeanCare Setting Facility Modifier None Typical Low $26.92 Median $3,162.28 Typical High $5,888.44 | Facility | None | $26.92 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $85.11 | Professional | None | $42.66 | $56.23 | $85.11 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $912.01 Typical High $1,778.28 | Facility | None | $51.29 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $109.65 Typical High $2,187.76 | Professional | None | $37.15 | $109.65 | $2,187.76 |
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 $44.67 Median $72.44 Typical High $97.72 | Professional | None | $44.67 | $72.44 | $97.72 |
Prevea360 Setting Facility Modifier None Typical Low $22.39 Median $35.48 Typical High $66.07 | Facility | None | $22.39 | $35.48 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $112.20 | Professional | None | $39.81 | $72.44 | $112.20 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $2,691.53 | Facility | None | $630.96 | $812.83 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $63.10 | Professional | None | $27.54 | $37.15 | $63.10 |
Security Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | None | $45.71 | $45.71 | $60.26 |
Security Health Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $158.49 | Professional | None | $54.95 | $120.23 | $158.49 |
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 $29.51 Median $67.61 Typical High $134.90 | Professional | None | $29.51 | $67.61 | $134.90 |
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 $10.47 Median $10.47 Typical High $13.80 | Facility | 52 · Reduced service | $10.47 | $10.47 | $13.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $5.50 | Facility | 53 · Discontinued | $4.17 | $4.17 | $5.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $15.49 Median $15.49 Typical High $20.89 | Facility | 54 · Surgery only | $15.49 | $15.49 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $4.17 | Facility | 55 · Aftercare only | $3.09 | $3.09 | $4.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.75 | Facility | 56 · Pre-op care only | $2.09 | $2.09 | $2.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $13.80 Typical High $199.53 | Professional | 52 · Reduced service | $10.47 | $13.80 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.50 Typical High $79.43 | Professional | 53 · Discontinued | $4.17 | $5.50 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $20.89 Typical High $302.00 | Professional | 54 · Surgery only | $15.49 | $20.89 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.17 Typical High $60.26 | Professional | 55 · Aftercare only | $3.09 | $4.17 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.75 Typical High $39.81 | Professional | 56 · Pre-op care only | $2.09 | $2.75 | $39.81 |
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
$87.10
AK $100NJ $28.84
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.