How much rates vary
Facilitymedian $1,380 · 10th to 90th $162 to $4,074Professionalmedian $295 · 10th to 90th $110 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 $81.28 Median $162.18 Typical High $14,454.40 | Facility | None | $81.28 | $162.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $1,905.46 | Professional | None | $81.28 | $162.18 | $1,905.46 |
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 $112.20 Median $309.03 Typical High $630.96 | Professional | None | $112.20 | $309.03 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $457.09 Typical High $933.25 | Professional | 50 · Both sides | $165.96 | $457.09 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $436.52 Typical High $812.83 | Facility | None | $50.12 | $436.52 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $676.08 | Professional | None | $147.91 | $295.12 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $2,630.27 Typical High $5,128.61 | Facility | None | $97.72 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $436.52 | Professional | None | $154.88 | $281.84 | $436.52 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $416.87 Typical High $645.65 | Professional | 50 · Both sides | $229.09 | $416.87 | $645.65 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $912.01 Typical High $1,778.28 | Facility | None | $162.18 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $660.69 Typical High $2,238.72 | Professional | None | $186.21 | $660.69 | $2,238.72 |
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 $199.53 Median $323.59 Typical High $446.68 | Professional | None | $199.53 | $323.59 | $446.68 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $162.18 Typical High $338.84 | Facility | None | $81.28 | $162.18 | $338.84 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $645.65 | Professional | None | $162.18 | $346.74 | $645.65 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $812.83 | Facility | None | $50.12 | $50.12 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $363.08 | Professional | None | $147.91 | $295.12 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $549.54 | Professional | None | $269.15 | $269.15 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,071.52 | Professional | None | $346.74 | $524.81 | $1,071.52 |
The Alliance Setting Professional Modifier None Typical Low $158.49 Median $380.19 Typical High $977.24 | Professional | None | $158.49 | $380.19 | $977.24 |
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 $97.72 Median $245.47 Typical High $691.83 | Professional | None | $97.72 | $245.47 | $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 $40.74 Median $40.74 Typical High $81.28 | Facility | 52 · Reduced service | $40.74 | $40.74 | $81.28 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $32.36 | Facility | 53 · Discontinued | $16.22 | $16.22 | $32.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $120.23 | Facility | 54 · Surgery only | $61.66 | $61.66 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $24.55 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $16.22 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $16.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $81.28 Typical High $1,122.02 | Professional | 52 · Reduced service | $40.74 | $81.28 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $32.36 Typical High $446.68 | Professional | 53 · Discontinued | $16.22 | $32.36 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $120.23 Typical High $1,659.59 | Professional | 54 · Surgery only | $61.66 | $120.23 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $24.55 Typical High $331.13 | Professional | 55 · Aftercare only | $12.30 | $24.55 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $16.22 Typical High $223.87 | Professional | 56 · Pre-op care only | $8.13 | $16.22 | $223.87 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $75.86 Median $141.25 Typical High $218.78 | Professional | 51 · Multiple procedures | $75.86 | $141.25 | $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· 2nd of 51
$316
AK $417VA $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.