How much rates vary
Facilitymedian $1,380 · 10th to 90th $178 to $3,890Professionalmedian $209 · 10th to 90th $72 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 $66.07 Median $66.07 Typical High $14,454.40 | Facility | None | $66.07 | $66.07 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $794.33 | Professional | None | $66.07 | $66.07 | $794.33 |
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 $77.62 Median $229.09 Typical High $346.74 | Professional | None | $77.62 | $229.09 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $316.23 Typical High $1,023.29 | Facility | None | $50.12 | $316.23 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $234.42 | Professional | None | $79.43 | $117.49 | $234.42 |
DeanCare Setting Facility Modifier None Typical Low $85.11 Median $2,818.38 Typical High $5,370.32 | Facility | None | $85.11 | $2,818.38 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $1,000.00 Typical High $1,778.28 | Facility | None | $154.88 | $1,000.00 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $213.80 Typical High $575.44 | Professional | None | $77.62 | $213.80 | $575.44 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $85.11 Typical High $154.88 | Facility | None | $54.95 | $85.11 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $251.19 | Professional | None | $85.11 | $181.97 | $251.19 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,122.02 | Facility | None | $50.12 | $741.31 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $181.97 | Professional | None | $75.86 | $87.10 | $181.97 |
Security Health Setting Professional Modifier None Typical Low $93.33 Median $263.03 Typical High $263.03 | Professional | None | $93.33 | $263.03 | $263.03 |
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 $77.62 Median $158.49 Typical High $309.03 | Professional | None | $77.62 | $158.49 | $309.03 |
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 $32.36 Median $32.36 Typical High $398.11 | Professional | 52 · Reduced service | $32.36 | $32.36 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $158.49 | Professional | 53 · Discontinued | $13.18 | $13.18 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $588.84 | Professional | 54 · Surgery only | $48.98 | $48.98 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $120.23 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $79.43 |
Where Wisconsin sits
The same service costs 5.5 times more in Arkansas 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· 4th of 51
$257
AR $331KY $60.26
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.