How much rates vary
Facilitymedian $1,380 · 10th to 90th $72 to $3,890Professionalmedian $141 · 10th to 90th $50 to $347
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 $31.62 Median $72.44 Typical High $14,454.40 | Facility | None | $31.62 | $72.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $72.44 Typical High $478.63 | Professional | None | $31.62 | $72.44 | $478.63 |
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 $70.79 Median $165.96 Typical High $346.74 | Professional | None | $70.79 | $165.96 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $102.33 | Professional | None | $77.62 | $83.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $229.09 Typical High $354.81 | Facility | None | $50.12 | $229.09 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $95.50 Typical High $263.03 | Professional | None | $42.66 | $95.50 | $263.03 |
DeanCare Setting Facility Modifier None Typical Low $40.74 Median $2,630.27 Typical High $5,128.61 | Facility | None | $40.74 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $229.09 | Professional | None | $66.07 | $123.03 | $229.09 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $912.01 Typical High $1,778.28 | Facility | None | $93.33 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $645.65 | Professional | None | $83.18 | $257.04 | $645.65 |
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 $81.28 Median $123.03 Typical High $223.87 | Professional | None | $81.28 | $123.03 | $223.87 |
Prevea360 Setting Facility Modifier None Typical Low $30.90 Median $72.44 Typical High $154.88 | Facility | None | $30.90 | $72.44 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $295.12 | Professional | None | $75.86 | $162.18 | $295.12 |
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 $42.66 Median $81.28 Typical High $134.90 | Professional | None | $42.66 | $81.28 | $134.90 |
Security Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $169.82 | Professional | None | $67.61 | $67.61 | $169.82 |
Security Health Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $436.52 | Professional | None | $85.11 | $173.78 | $436.52 |
The Alliance Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $275.42 | Professional | None | $64.57 | $165.96 | $275.42 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $42.66 Median $125.89 Typical High $316.23 | Professional | None | $42.66 | $125.89 | $316.23 |
11 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 $15.85 Median $15.85 Typical High $36.31 | Facility | 52 · Reduced service | $15.85 | $15.85 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $14.45 | Facility | 53 · Discontinued | $6.31 | $6.31 | $14.45 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $23.99 Median $23.99 Typical High $54.95 | Facility | 54 · Surgery only | $23.99 | $23.99 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $10.96 | Facility | 55 · Aftercare only | $4.79 | $4.79 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $7.24 | Facility | 56 · Pre-op care only | $3.16 | $3.16 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $36.31 Typical High $245.47 | Professional | 52 · Reduced service | $15.85 | $36.31 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $14.45 Typical High $100.00 | Professional | 53 · Discontinued | $6.31 | $14.45 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $54.95 Typical High $371.54 | Professional | 54 · Surgery only | $23.99 | $54.95 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $10.96 Typical High $74.13 | Professional | 55 · Aftercare only | $4.79 | $10.96 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $7.24 Typical High $50.12 | Professional | 56 · Pre-op care only | $3.16 | $7.24 | $50.12 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $60.26 Typical High $112.20 | Professional | 51 · Multiple procedures | $32.36 | $60.26 | $112.20 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$166
AK $178KY $47.86
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.