How much rates vary
Facilitymedian $1,259 · 10th to 90th $158 to $2,818Professionalmedian $363 · 10th to 90th $107 to $1,380
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 $77.62 Median $295.12 Typical High $14,454.40 | Facility | None | $77.62 | $295.12 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $295.12 Typical High $2,238.72 | Professional | None | $77.62 | $295.12 | $2,238.72 |
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 $117.49 Median $316.23 Typical High $645.65 | Professional | None | $117.49 | $316.23 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $478.63 Typical High $977.24 | Professional | 50 · Both sides | $177.83 | $478.63 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $933.25 Typical High $1,380.38 | Facility | None | $812.83 | $933.25 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $371.54 Typical High $1,318.26 | Professional | None | $141.25 | $371.54 | $1,318.26 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $2,754.23 Typical High $5,128.61 | Facility | None | $128.82 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $831.76 | Professional | None | $147.91 | $275.42 | $831.76 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $407.38 Typical High $1,258.93 | Professional | 50 · Both sides | $218.78 | $407.38 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $1,318.26 Typical High $1,778.28 | Facility | None | $158.49 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,148.15 Typical High $2,691.53 | Professional | None | $363.08 | $1,148.15 | $2,691.53 |
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 $194.98 Median $446.68 Typical High $776.25 | Professional | None | $194.98 | $446.68 | $776.25 |
Prevea360 Setting Facility Modifier None Typical Low $87.10 Median $169.82 Typical High $512.86 | Facility | None | $87.10 | $169.82 | $512.86 |
Quartz Setting Professional Modifier None Typical Low $123.03 Median $363.08 Typical High $1,071.52 | Professional | None | $123.03 | $363.08 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $363.08 Typical High $645.65 | Professional | None | $141.25 | $363.08 | $645.65 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $1,071.52 | Professional | None | $263.03 | $263.03 | $1,071.52 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $2,187.76 | Professional | None | $398.11 | $630.96 | $2,187.76 |
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 $120.23 Median $380.19 Typical High $1,318.26 | Professional | None | $120.23 | $380.19 | $1,318.26 |
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 $38.90 Median $38.90 Typical High $147.91 | Facility | 52 · Reduced service | $38.90 | $38.90 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $58.88 | Facility | 53 · Discontinued | $15.49 | $15.49 | $58.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $223.87 | Facility | 54 · Surgery only | $58.88 | $58.88 | $223.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $44.67 | Facility | 55 · Aftercare only | $11.75 | $11.75 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $29.51 | Facility | 56 · Pre-op care only | $7.76 | $7.76 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $147.91 Typical High $1,174.90 | Professional | 52 · Reduced service | $38.90 | $147.91 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $58.88 Typical High $467.74 | Professional | 53 · Discontinued | $15.49 | $58.88 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $223.87 Typical High $1,737.80 | Professional | 54 · Surgery only | $58.88 | $223.87 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $44.67 Typical High $346.74 | Professional | 55 · Aftercare only | $11.75 | $44.67 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $29.51 Typical High $234.42 | Professional | 56 · Pre-op care only | $7.76 | $29.51 | $234.42 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $138.04 Typical High $416.87 | Professional | 51 · Multiple procedures | $72.44 | $138.04 | $416.87 |
Where Wisconsin sits
The same service costs 4.2 times more in Washington 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· 3rd of 51
$389
WA $447VA $107
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.