How much rates vary
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 $363.08 Median $6,456.54 Typical High $14,454.40 | Facility | None | $363.08 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $6,918.31 | Professional | None | $363.08 | $363.08 | $6,918.31 |
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 $269.15 Median $316.23 Typical High $316.23 | Professional | None | $269.15 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,548.82 Typical High $4,897.79 | Facility | None | $831.76 | $1,548.82 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $831.76 | Professional | None | $575.44 | $645.65 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $3,311.31 Typical High $6,025.60 | Facility | None | $933.25 | $3,311.31 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $6,025.60 Typical High $11,220.18 | Facility | None | $1,148.15 | $6,025.60 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 |
Prevea360 Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $933.25 | Facility | None | $371.54 | $371.54 | $933.25 |
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 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 |
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 $181.97 Median $181.97 Typical High $3,467.37 | Professional | 52 · Reduced service | $181.97 | $181.97 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $1,380.38 | Professional | 53 · Discontinued | $72.44 | $72.44 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $5,248.07 | Professional | 54 · Surgery only | $275.42 | $275.42 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $1,047.13 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $691.83 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $691.83 |
Where Wisconsin sits
The same service costs 64.6 times more in Wisconsin than in Montana. 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· 1st of 51
$5,129
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.