How much rates vary
Facilitymedian $1,023 · 10th to 90th $182 to $6,166Professionalmedian $282 · 10th to 90th $112 to $912
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 $112.20 Median $1,905.46 Typical High $14,454.40 | Facility | None | $112.20 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $1,479.11 | Professional | None | $112.20 | $112.20 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,456.54 | Facility | None | $6,025.60 | $6,025.60 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $426.58 Typical High $891.25 | Professional | None | $114.82 | $426.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $346.74 Typical High $1,479.11 | Facility | None | $302.00 | $346.74 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $575.44 | Professional | None | $186.21 | $204.17 | $575.44 |
DeanCare Setting Facility Modifier None Typical Low $134.90 Median $7,943.28 Typical High $14,791.08 | Facility | None | $134.90 | $7,943.28 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $954.99 Typical High $1,778.28 | Facility | None | $204.17 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $281.84 Typical High $1,621.81 | Professional | None | $128.82 | $281.84 | $1,621.81 |
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 $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $239.88 | Facility | None | $112.20 | $134.90 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $275.42 Typical High $478.63 | Professional | None | $131.83 | $275.42 | $478.63 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $7,079.46 | Facility | None | $758.58 | $1,071.52 | $7,079.46 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | None | $204.17 | $204.17 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $588.84 | Professional | None | $346.74 | $588.84 | $588.84 |
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 $123.03 Median $234.42 Typical High $575.44 | Professional | None | $123.03 | $234.42 | $575.44 |
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 $56.23 Median $56.23 Typical High $741.31 | Professional | 52 · Reduced service | $56.23 | $56.23 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $295.12 | Professional | 53 · Discontinued | $22.39 | $22.39 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $1,096.48 | Professional | 54 · Surgery only | $83.18 | $83.18 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $218.78 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $147.91 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $147.91 |
Where Wisconsin sits
The same service costs 4.0 times more in Alaska than in Delaware. 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
$339
AK $468DE $117
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.