How much rates vary
Facilitymedian $1,230 · 10th to 90th $98 to $2,818Professionalmedian $219 · 10th to 90th $66 to $741
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 $47.86 Median $154.88 Typical High $14,454.40 | Facility | None | $47.86 | $154.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $154.88 Typical High $933.25 | Professional | None | $47.86 | $154.88 | $933.25 |
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 $72.44 Median $190.55 Typical High $407.38 | Professional | None | $72.44 | $190.55 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $288.40 Typical High $602.56 | Professional | 50 · Both sides | $109.65 | $288.40 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | None | $177.83 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $489.78 Typical High $724.44 | Facility | None | $426.58 | $489.78 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $229.09 Typical High $758.58 | Professional | None | $87.10 | $229.09 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $2,754.23 Typical High $5,128.61 | Facility | None | $79.43 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $436.52 | Professional | None | $91.20 | $165.96 | $436.52 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $251.19 Typical High $660.69 | Professional | 50 · Both sides | $134.90 | $251.19 | $660.69 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $1,202.26 Typical High $2,041.74 | Facility | None | $144.54 | $1,202.26 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $602.56 Typical High $1,778.28 | Professional | None | $194.98 | $602.56 | $1,778.28 |
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 $123.03 Median $229.09 Typical High $457.09 | Professional | None | $123.03 | $229.09 | $457.09 |
Prevea360 Setting Facility Modifier None Typical Low $53.70 Median $102.33 Typical High $269.15 | Facility | None | $53.70 | $102.33 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $537.03 | Professional | None | $74.13 | $213.80 | $537.03 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $223.87 Typical High $354.81 | Professional | None | $87.10 | $223.87 | $354.81 |
Security Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $562.34 | Professional | None | $162.18 | $162.18 | $562.34 |
Security Health Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $1,122.02 | Professional | None | $169.82 | $426.58 | $1,122.02 |
The Alliance Setting Professional Modifier None Typical Low $89.13 Median $288.40 Typical High $741.31 | Professional | None | $89.13 | $288.40 | $741.31 |
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 $74.13 Median $223.87 Typical High $691.83 | Professional | None | $74.13 | $223.87 | $691.83 |
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 $23.99 Median $23.99 Typical High $77.62 | Facility | 52 · Reduced service | $23.99 | $23.99 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $30.90 | Facility | 53 · Discontinued | $9.77 | $9.77 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $36.31 Median $36.31 Typical High $117.49 | Facility | 54 · Surgery only | $36.31 | $36.31 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $23.44 | Facility | 55 · Aftercare only | $7.24 | $7.24 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $15.49 | Facility | 56 · Pre-op care only | $4.79 | $4.79 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $77.62 Typical High $758.58 | Professional | 52 · Reduced service | $23.99 | $77.62 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $30.90 Typical High $302.00 | Professional | 53 · Discontinued | $9.77 | $30.90 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $117.49 Typical High $1,148.15 | Professional | 54 · Surgery only | $36.31 | $117.49 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $23.44 Typical High $229.09 | Professional | 55 · Aftercare only | $7.24 | $23.44 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $15.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $4.79 | $15.49 | $151.36 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $83.18 Typical High $218.78 | Professional | 51 · Multiple procedures | $45.71 | $83.18 | $218.78 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 5th of 51
$229
AK $257VA $66.07
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.