How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,318 to $11,220Professionalmedian $3,467 · 10th to 90th $1,175 to $5,495
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 $1,047.13 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,047.13 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $19,498.45 | Professional | None | $1,047.13 | $1,047.13 | $19,498.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $3,715.35 Typical High $5,495.41 | Professional | None | $1,412.54 | $3,715.35 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $5,623.41 Typical High $8,317.64 | Professional | 50 · Both sides | $2,137.96 | $5,623.41 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,548.13 Typical High $5,370.32 | Facility | None | $954.99 | $3,548.13 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,905.46 | $3,981.07 |
DeanCare Setting Facility Modifier None Typical Low $1,348.96 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,348.96 | $5,128.61 | $9,332.54 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,623.41 Typical High $11,220.18 | Facility | None | $1,174.90 | $5,623.41 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $10,715.19 | Professional | None | $1,318.26 | $3,388.44 | $10,715.19 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $2,511.89 | Facility | None | $812.83 | $1,348.96 | $2,511.89 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $3,890.45 | Professional | None | $1,318.26 | $2,818.38 | $3,890.45 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $3,235.94 Typical High $5,370.32 | Facility | None | $758.58 | $3,235.94 | $5,370.32 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $3,019.95 | Professional | None | $1,230.27 | $1,380.38 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $4,466.84 Typical High $4,466.84 | Professional | None | $954.99 | $4,466.84 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $2,511.89 Typical High $5,128.61 | Professional | None | $1,202.26 | $2,511.89 | $5,128.61 |
5 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 Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $9,772.37 | Professional | 52 · Reduced service | $524.81 | $524.81 | $9,772.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $3,890.45 | Professional | 53 · Discontinued | $208.93 | $208.93 | $3,890.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $14,791.08 | Professional | 54 · Surgery only | $794.33 | $794.33 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $2,951.21 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $2,951.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $1,949.84 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $1,949.84 |
Where Wisconsin sits
The same service costs 4.8 times more in Alaska than in New York. 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
$3,802
AK $5,129NY $1,072
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.