How much rates vary
Facilitymedian $2,951 · 10th to 90th $490 to $6,026Professionalmedian $513 · 10th to 90th $174 to $1,479
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 $151.36 Median $346.74 Typical High $14,454.40 | Facility | None | $151.36 | $346.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $1,905.46 | Professional | None | $151.36 | $346.74 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $660.69 Typical High $1,479.11 | Professional | None | $229.09 | $660.69 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,230.27 Typical High $2,187.76 | Facility | None | $724.44 | $1,230.27 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $977.24 | Professional | None | $162.18 | $363.08 | $977.24 |
DeanCare Setting Facility Modifier None Typical Low $173.78 Median $3,090.30 Typical High $5,370.32 | Facility | None | $173.78 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $851.14 | Professional | None | $257.04 | $389.05 | $851.14 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $2,187.76 Typical High $4,786.30 | Facility | None | $380.19 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $851.14 Typical High $1,479.11 | Professional | None | $269.15 | $851.14 | $1,479.11 |
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 $281.84 Median $512.86 Typical High $891.25 | Professional | None | $281.84 | $512.86 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $549.54 | Facility | None | $131.83 | $245.47 | $549.54 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $1,071.52 | Professional | None | $229.09 | $489.78 | $1,071.52 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $1,548.82 Typical High $2,454.71 | Facility | None | $724.44 | $1,548.82 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $478.63 | Professional | None | $162.18 | $363.08 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $660.69 | Professional | None | $281.84 | $281.84 | $660.69 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $707.95 Typical High $1,621.81 | Professional | None | $331.13 | $707.95 | $1,621.81 |
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 $158.49 Median $426.58 Typical High $1,148.15 | Professional | None | $158.49 | $426.58 | $1,148.15 |
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 $75.86 Median $75.86 Typical High $169.82 | Facility | 52 · Reduced service | $75.86 | $75.86 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $69.18 | Facility | 53 · Discontinued | $30.20 | $30.20 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $257.04 | Facility | 54 · Surgery only | $114.82 | $114.82 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $51.29 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $34.67 | Facility | 56 · Pre-op care only | $15.14 | $15.14 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $169.82 Typical High $954.99 | Professional | 52 · Reduced service | $75.86 | $169.82 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $69.18 Typical High $380.19 | Professional | 53 · Discontinued | $30.20 | $69.18 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $257.04 Typical High $1,445.44 | Professional | 54 · Surgery only | $114.82 | $257.04 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $51.29 Typical High $288.40 | Professional | 55 · Aftercare only | $22.91 | $51.29 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $34.67 Typical High $190.55 | Professional | 56 · Pre-op care only | $15.14 | $34.67 | $190.55 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska 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· 3rd of 51
$661
AK $708KY $182
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.