How much rates vary
Facilitymedian $1,000 · 10th to 90th $6 to $2,344Professionalmedian $9 · 10th to 90th $3 to $27
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 $1.78 Median $5.75 Typical High $14,454.40 | Facility | None | $1.78 | $5.75 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $5.75 Typical High $67.61 | Professional | None | $1.78 | $5.75 | $67.61 |
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 $2.95 Median $10.96 Typical High $26.30 | Professional | None | $2.95 | $10.96 | $26.30 |
CareSource Setting Professional Modifier None Typical Low $6.31 Median $6.61 Typical High $8.13 | Professional | None | $6.31 | $6.61 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $20.89 Typical High $812.83 | Facility | None | $18.20 | $20.89 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $7.41 Typical High $20.42 | Professional | None | $2.34 | $7.41 | $20.42 |
DeanCare Setting Facility Modifier None Typical Low $2.45 Median $2,630.27 Typical High $5,128.61 | Facility | None | $2.45 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $3.72 Median $7.94 Typical High $16.98 | Professional | None | $3.72 | $7.94 | $16.98 |
Medica Setting Facility Modifier None Typical Low $10.23 Median $812.83 Typical High $1,778.28 | Facility | None | $10.23 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $18.20 Typical High $83.18 | Professional | None | $6.92 | $18.20 | $83.18 |
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 $5.89 Median $10.72 Typical High $17.38 | Professional | None | $5.89 | $10.72 | $17.38 |
Prevea360 Setting Facility Modifier None Typical Low $1.91 Median $5.75 Typical High $13.80 | Facility | None | $1.91 | $5.75 | $13.80 |
Quartz Setting Professional Modifier None Typical Low $3.72 Median $9.12 Typical High $20.89 | Professional | None | $3.72 | $9.12 | $20.89 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $2,691.53 | Facility | None | $50.12 | $50.12 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $2.34 Median $6.31 Typical High $12.30 | Professional | None | $2.34 | $6.31 | $12.30 |
Security Health Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $12.88 | Professional | None | $3.98 | $3.98 | $12.88 |
Security Health Setting Professional Modifier None Typical Low $5.37 Median $11.75 Typical High $31.62 | Professional | None | $5.37 | $11.75 | $31.62 |
The Alliance Setting Professional Modifier None Typical Low $7.94 Median $20.42 Typical High $41.69 | Professional | None | $7.94 | $20.42 | $41.69 |
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 $2.82 Median $8.32 Typical High $22.39 | Professional | None | $2.82 | $8.32 | $22.39 |
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 $0.89 Median $0.89 Typical High $2.88 | Facility | 52 · Reduced service | $0.89 | $0.89 | $2.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $1.15 | Facility | 53 · Discontinued | $0.36 | $0.36 | $1.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1.35 Median $1.35 Typical High $4.37 | Facility | 54 · Surgery only | $1.35 | $1.35 | $4.37 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.87 | Facility | 55 · Aftercare only | $0.27 | $0.27 | $0.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.58 | Facility | 56 · Pre-op care only | $0.18 | $0.18 | $0.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.89 Median $2.88 Typical High $42.66 | Professional | 52 · Reduced service | $0.89 | $2.88 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $1.15 Typical High $17.38 | Professional | 53 · Discontinued | $0.36 | $1.15 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.35 Median $4.37 Typical High $64.57 | Professional | 54 · Surgery only | $1.35 | $4.37 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.87 Typical High $12.88 | Professional | 55 · Aftercare only | $0.27 | $0.87 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.58 Typical High $8.51 | Professional | 56 · Pre-op care only | $0.18 | $0.58 | $8.51 |
Where Wisconsin sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$11.22
AK $12.88NE $4.37
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.