How much rates vary
Facilitymedian $1,259 · 10th to 90th $138 to $2,818Professionalmedian $295 · 10th to 90th $115 to $724
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 $63.10 Median $138.04 Typical High $14,454.40 | Facility | None | $63.10 | $138.04 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $1,288.25 | Professional | None | $63.10 | $138.04 | $1,288.25 |
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 $144.54 Median $316.23 Typical High $707.95 | Professional | None | $144.54 | $316.23 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $478.63 Typical High $1,047.13 | Professional | 50 · Both sides | $213.80 | $478.63 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $741.31 | Facility | None | $436.52 | $489.78 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $467.74 | Professional | None | $141.25 | $223.87 | $467.74 |
DeanCare Setting Facility Modifier None Typical Low $114.82 Median $2,754.23 Typical High $5,128.61 | Facility | None | $114.82 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $446.68 | Professional | None | $138.04 | $257.04 | $446.68 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $380.19 Typical High $676.08 | Professional | 50 · Both sides | $204.17 | $380.19 | $676.08 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $1,318.26 Typical High $1,778.28 | Facility | None | $147.91 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $616.60 Typical High $1,737.80 | Professional | None | $218.78 | $616.60 | $1,737.80 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,344.23 | Facility | None | $831.76 | $1,819.70 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $467.74 | Professional | None | $173.78 | $245.47 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $147.91 Typical High $323.59 | Facility | None | $81.28 | $147.91 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $251.19 Typical High $524.81 | Professional | None | $112.20 | $251.19 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $363.08 | Professional | None | $141.25 | $213.80 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $316.23 | Professional | None | $141.25 | $141.25 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $831.76 | Professional | None | $144.54 | $338.84 | $831.76 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $112.20 Median $275.42 Typical High $645.65 | Professional | None | $112.20 | $275.42 | $645.65 |
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 $31.62 Median $31.62 Typical High $69.18 | Facility | 52 · Reduced service | $31.62 | $31.62 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $27.54 | Facility | 53 · Discontinued | $12.59 | $12.59 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $104.71 | Facility | 54 · Surgery only | $47.86 | $47.86 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $20.89 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $13.80 | Facility | 56 · Pre-op care only | $6.31 | $6.31 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $69.18 Typical High $645.65 | Professional | 52 · Reduced service | $31.62 | $69.18 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $27.54 Typical High $257.04 | Professional | 53 · Discontinued | $12.59 | $27.54 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $104.71 Typical High $954.99 | Professional | 54 · Surgery only | $47.86 | $104.71 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $20.89 Typical High $190.55 | Professional | 55 · Aftercare only | $9.55 | $20.89 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $13.80 Typical High $128.82 | Professional | 56 · Pre-op care only | $6.31 | $13.80 | $128.82 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $128.82 Typical High $223.87 | Professional | 51 · Multiple procedures | $69.18 | $128.82 | $223.87 |
Where Wisconsin sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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
$309
WI $309UT $120
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.