How much rates vary
Facilitymedian $2,630 · 10th to 90th $457 to $5,623Professionalmedian $646 · 10th to 90th $234 to $1,413
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 $213.80 Median $331.13 Typical High $14,454.40 | Facility | None | $213.80 | $331.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $2,344.23 | Professional | None | $213.80 | $331.13 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $794.33 Typical High $1,479.11 | Professional | None | $263.03 | $794.33 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $1,174.90 Typical High $2,187.76 | Professional | 50 · Both sides | $398.11 | $1,174.90 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $2,137.96 | Facility | None | $676.08 | $1,096.48 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $891.25 | Professional | None | $223.87 | $380.19 | $891.25 |
DeanCare Setting Facility Modifier None Typical Low $234.42 Median $2,570.40 Typical High $4,786.30 | Facility | None | $234.42 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $851.14 | Professional | None | $354.81 | $537.03 | $851.14 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $2,187.76 Typical High $5,248.07 | Facility | None | $380.19 | $2,187.76 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $831.76 Typical High $2,187.76 | Professional | None | $309.03 | $831.76 | $2,187.76 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $812.83 | Professional | None | $380.19 | $645.65 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $524.81 | Facility | None | $181.97 | $302.00 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $1,047.13 | Professional | None | $288.40 | $562.34 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,344.23 | Facility | None | $630.96 | $1,548.82 | $2,344.23 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $549.54 | Professional | None | $223.87 | $346.74 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $616.60 | Professional | None | $398.11 | $398.11 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,513.56 | Professional | None | $630.96 | $1,000.00 | $1,513.56 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,786.30 | Facility | None | $707.95 | $2,818.38 | $4,786.30 |
United Setting Professional Modifier None Typical Low $223.87 Median $588.84 Typical High $1,071.52 | Professional | None | $223.87 | $588.84 | $1,071.52 |
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 $107.15 Median $107.15 Typical High $165.96 | Facility | 52 · Reduced service | $107.15 | $107.15 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $66.07 | Facility | 53 · Discontinued | $42.66 | $42.66 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $245.47 | Facility | 54 · Surgery only | $158.49 | $158.49 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $48.98 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $33.11 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $165.96 Typical High $1,202.26 | Professional | 52 · Reduced service | $107.15 | $165.96 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $66.07 Typical High $478.63 | Professional | 53 · Discontinued | $42.66 | $66.07 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $1,778.28 | Professional | 54 · Surgery only | $158.49 | $245.47 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $48.98 Typical High $363.08 | Professional | 55 · Aftercare only | $31.62 | $48.98 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.11 Typical High $239.88 | Professional | 56 · Pre-op care only | $21.38 | $33.11 | $239.88 |
Where Wisconsin sits
The same service costs 3.1 times more in Alaska than in New York. 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
$776
AK $794NY $257
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.