How much rates vary
Facilitymedian $1,202 · 10th to 90th $138 to $3,802Professionalmedian $204 · 10th to 90th $81 to $479
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 $141.25 Typical High $14,454.40 | Facility | None | $77.62 | $141.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $588.84 | Professional | None | $77.62 | $138.04 | $588.84 |
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 $87.10 Median $229.09 Typical High $416.87 | Professional | None | $87.10 | $229.09 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $295.12 Typical High $707.95 | Facility | None | $138.04 | $295.12 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $398.11 | Professional | None | $83.18 | $147.91 | $398.11 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $2,630.27 Typical High $5,128.61 | Facility | None | $70.79 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $354.81 | Professional | None | $128.82 | $190.55 | $354.81 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $912.01 Typical High $1,778.28 | Facility | None | $123.03 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $371.54 Typical High $616.60 | Professional | None | $125.89 | $371.54 | $616.60 |
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 $138.04 Median $257.04 Typical High $371.54 | Professional | None | $138.04 | $257.04 | $371.54 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $213.80 | Facility | None | $54.95 | $100.00 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $446.68 | Professional | None | $117.49 | $234.42 | $446.68 |
Quartz Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $1,071.52 | Facility | None | $134.90 | $208.93 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $194.98 | Professional | None | $83.18 | $147.91 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $275.42 | Professional | None | $141.25 | $141.25 | $275.42 |
Security Health Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $676.08 | Professional | None | $162.18 | $363.08 | $676.08 |
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 $77.62 Median $208.93 Typical High $478.63 | Professional | None | $77.62 | $208.93 | $478.63 |
10 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 $70.79 | Facility | 52 · Reduced service | $38.90 | $38.90 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $28.18 | Facility | 53 · Discontinued | $15.49 | $15.49 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $104.71 | Facility | 54 · Surgery only | $57.54 | $57.54 | $104.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $20.89 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $14.13 | Facility | 56 · Pre-op care only | $7.76 | $7.76 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $70.79 Typical High $302.00 | Professional | 52 · Reduced service | $38.90 | $70.79 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $28.18 Typical High $120.23 | Professional | 53 · Discontinued | $15.49 | $28.18 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $104.71 Typical High $446.68 | Professional | 54 · Surgery only | $57.54 | $104.71 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $20.89 Typical High $89.13 | Professional | 55 · Aftercare only | $11.48 | $20.89 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $14.13 Typical High $60.26 | Professional | 56 · Pre-op care only | $7.76 | $14.13 | $60.26 |
Where Wisconsin sits
The same service costs 3.9 times more in Wisconsin than in Kentucky. 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· 1st of 51
$251
WI $251KY $64.57
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.