How much rates vary
Facilitymedian $1,202 · 10th to 90th $34 to $3,548Professionalmedian $65 · 10th to 90th $28 to $162
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 $17.78 Median $17.78 Typical High $31.62 | Facility | None | $17.78 | $17.78 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $31.62 Typical High $275.42 | Professional | None | $17.78 | $31.62 | $275.42 |
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 $24.55 Median $72.44 Typical High $144.54 | Professional | None | $24.55 | $72.44 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $50.12 Typical High $100.00 | Facility | None | $30.90 | $50.12 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $57.54 Typical High $134.90 | Professional | None | $32.36 | $57.54 | $134.90 |
DeanCare Setting Facility Modifier None Typical Low $21.38 Median $2,630.27 Typical High $5,128.61 | Facility | None | $21.38 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $85.11 | Professional | None | $33.88 | $56.23 | $85.11 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $912.01 Typical High $1,778.28 | Facility | None | $52.48 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $141.25 Typical High $338.84 | Professional | None | $41.69 | $141.25 | $338.84 |
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 $39.81 Median $95.50 Typical High $125.89 | Professional | None | $39.81 | $95.50 | $125.89 |
Prevea360 Setting Facility Modifier None Typical Low $18.62 Median $34.67 Typical High $61.66 | Facility | None | $18.62 | $34.67 | $61.66 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $72.44 Typical High $128.82 | Professional | None | $33.88 | $72.44 | $128.82 |
Quartz Setting Facility Modifier None Typical Low $30.20 Median $40.74 Typical High $54.95 | Facility | None | $30.20 | $40.74 | $54.95 |
Quartz Setting Professional Modifier None Typical Low $32.36 Median $57.54 Typical High $70.79 | Professional | None | $32.36 | $57.54 | $70.79 |
Security Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $109.65 | Professional | None | $63.10 | $63.10 | $109.65 |
Security Health Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $257.04 | Professional | None | $60.26 | $134.90 | $257.04 |
The Alliance Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $26.92 Median $63.10 Typical High $141.25 | Professional | None | $26.92 | $63.10 | $141.25 |
9 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 $8.91 Median $8.91 Typical High $15.85 | Facility | 52 · Reduced service | $8.91 | $8.91 | $15.85 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $6.31 | Facility | 53 · Discontinued | $3.55 | $3.55 | $6.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $4.68 | Facility | 55 · Aftercare only | $2.69 | $2.69 | $4.68 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $3.16 | Facility | 56 · Pre-op care only | $1.78 | $1.78 | $3.16 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $15.85 Typical High $138.04 | Professional | 52 · Reduced service | $8.91 | $15.85 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $6.31 Typical High $56.23 | Professional | 53 · Discontinued | $3.55 | $6.31 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $4.68 Typical High $41.69 | Professional | 55 · Aftercare only | $2.69 | $4.68 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $3.16 Typical High $27.54 | Professional | 56 · Pre-op care only | $1.78 | $3.16 | $27.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $16.60 Median $28.18 Typical High $42.66 | Professional | 51 · Multiple procedures | $16.60 | $28.18 | $42.66 |
Where Wisconsin sits
The same service costs 3.5 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
$72.44
AK $83.18VA $23.99
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.