How much rates vary
Facilitymedian $1,202 · 10th to 90th $56 to $3,802Professionalmedian $112 · 10th to 90th $48 to $295
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 $35.48 Median $51.29 Typical High $14,454.40 | Facility | None | $35.48 | $51.29 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $363.08 | Professional | None | $35.48 | $51.29 | $363.08 |
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 $50.12 Median $141.25 Typical High $281.84 | Professional | None | $50.12 | $141.25 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $138.04 Typical High $707.95 | Facility | None | $46.77 | $138.04 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $218.78 | Professional | None | $60.26 | $93.33 | $218.78 |
DeanCare Setting Facility Modifier None Typical Low $42.66 Median $2,630.27 Typical High $5,128.61 | Facility | None | $42.66 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $131.83 | Professional | None | $63.10 | $89.13 | $131.83 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $912.01 Typical High $2,089.30 | Facility | None | $83.18 | $912.01 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $218.78 Typical High $616.60 | Professional | None | $60.26 | $218.78 | $616.60 |
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 $64.57 Median $114.82 Typical High $165.96 | Professional | None | $64.57 | $114.82 | $165.96 |
Prevea360 Setting Facility Modifier None Typical Low $36.31 Median $57.54 Typical High $107.15 | Facility | None | $36.31 | $57.54 | $107.15 |
Quartz Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $223.87 | Professional | None | $66.07 | $120.23 | $223.87 |
Quartz Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $1,071.52 | Facility | None | $46.77 | $70.79 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $112.20 | Professional | None | $64.57 | $91.20 | $112.20 |
Security Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $173.78 | Professional | None | $123.03 | $123.03 | $173.78 |
Security Health Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $338.84 | Professional | None | $125.89 | $234.42 | $338.84 |
The Alliance Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $371.54 | Professional | None | $75.86 | $208.93 | $371.54 |
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 $44.67 Median $87.10 Typical High $245.47 | Professional | None | $44.67 | $87.10 | $245.47 |
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 $17.78 Median $17.78 Typical High $25.70 | Facility | 52 · Reduced service | $17.78 | $17.78 | $25.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $10.23 | Facility | 53 · Discontinued | $7.08 | $7.08 | $10.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $26.92 Median $26.92 Typical High $38.90 | Facility | 54 · Surgery only | $26.92 | $26.92 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $7.76 | Facility | 55 · Aftercare only | $5.37 | $5.37 | $7.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.13 | Facility | 56 · Pre-op care only | $3.55 | $3.55 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $25.70 Typical High $194.98 | Professional | 52 · Reduced service | $17.78 | $25.70 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $10.23 Typical High $77.62 | Professional | 53 · Discontinued | $7.08 | $10.23 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $38.90 Typical High $295.12 | Professional | 54 · Surgery only | $26.92 | $38.90 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.76 Typical High $58.88 | Professional | 55 · Aftercare only | $5.37 | $7.76 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.13 Typical High $38.90 | Professional | 56 · Pre-op care only | $3.55 | $5.13 | $38.90 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $31.62 Median $44.67 Typical High $64.57 | Professional | 51 · Multiple procedures | $31.62 | $44.67 | $64.57 |
Where Wisconsin sits
The same service costs 4.2 times more in Alaska than in New York. 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
$126
AK $186NY $44.67
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.