How much rates vary
Facilitymedian $1,445 · 10th to 90th $112 to $4,266Professionalmedian $129 · 10th to 90th $45 to $219
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 $37.15 Median $1,905.46 Typical High $14,454.40 | Facility | None | $37.15 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $562.34 | Professional | None | $37.15 | $37.15 | $562.34 |
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 $57.54 Median $138.04 Typical High $218.78 | Professional | None | $57.54 | $138.04 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $173.78 | Facility | None | $50.12 | $112.20 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $239.88 | Professional | None | $48.98 | $87.10 | $239.88 |
DeanCare Setting Facility Modifier None Typical Low $47.86 Median $2,818.38 Typical High $5,128.61 | Facility | None | $47.86 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $128.82 | Professional | None | $75.86 | $77.62 | $128.82 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $954.99 Typical High $1,778.28 | Facility | None | $128.82 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $147.91 Typical High $616.60 | Professional | None | $50.12 | $147.91 | $616.60 |
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 $61.66 Median $104.71 Typical High $134.90 | Professional | None | $61.66 | $104.71 | $134.90 |
Prevea360 Setting Facility Modifier None Typical Low $37.15 Median $47.86 Typical High $93.33 | Facility | None | $37.15 | $47.86 | $93.33 |
Quartz Setting Professional Modifier None Typical Low $42.66 Median $91.20 Typical High $186.21 | Professional | None | $42.66 | $91.20 | $186.21 |
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 $47.86 Median $48.98 Typical High $109.65 | Professional | None | $47.86 | $48.98 | $109.65 |
Security Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Security Health Setting Professional Modifier None Typical Low $85.11 Median $186.21 Typical High $239.88 | Professional | None | $85.11 | $186.21 | $239.88 |
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 $44.67 Median $112.20 Typical High $190.55 | Professional | None | $44.67 | $112.20 | $190.55 |
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 $18.62 Median $18.62 Typical High $281.84 | Professional | 52 · Reduced service | $18.62 | $18.62 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $112.20 | Professional | 53 · Discontinued | $7.41 | $7.41 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $27.54 Typical High $426.58 | Professional | 54 · Surgery only | $27.54 | $27.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $85.11 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $56.23 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $56.23 |
Where Wisconsin sits
The same service costs 13.8 times more in Oklahoma 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· 5th of 51
$155
OK $575NY $41.69
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.