How much rates vary
Facilitymedian $1,230 · 10th to 90th $214 to $3,802Professionalmedian $468 · 10th to 90th $166 to $1,072
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 $251.19 Typical High $14,454.40 | Facility | None | $151.36 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $1,905.46 | Professional | None | $151.36 | $245.47 | $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 $190.55 Median $630.96 Typical High $1,122.02 | Professional | None | $190.55 | $630.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $524.81 Typical High $977.24 | Facility | None | $213.80 | $524.81 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $707.95 | Professional | None | $162.18 | $281.84 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $144.54 Median $2,630.27 Typical High $5,128.61 | Facility | None | $144.54 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $575.44 | Professional | None | $257.04 | $389.05 | $575.44 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $954.99 Typical High $1,778.28 | Facility | None | $173.78 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $630.96 Typical High $1,621.81 | Professional | None | $223.87 | $630.96 | $1,621.81 |
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 $288.40 Median $489.78 Typical High $660.69 | Professional | None | $288.40 | $489.78 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $354.81 | Facility | None | $131.83 | $213.80 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $724.44 | Professional | None | $218.78 | $416.87 | $724.44 |
Quartz Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $1,096.48 | Facility | None | $208.93 | $316.23 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $389.05 | Professional | None | $162.18 | $269.15 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $489.78 | Professional | None | $288.40 | $288.40 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $707.95 Typical High $1,202.26 | Professional | None | $331.13 | $707.95 | $1,202.26 |
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 $162.18 Median $416.87 Typical High $812.83 | Professional | None | $162.18 | $416.87 | $812.83 |
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 $125.89 | Facility | 52 · Reduced service | $75.86 | $75.86 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $50.12 | Facility | 53 · Discontinued | $30.90 | $30.90 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $190.55 | Facility | 54 · Surgery only | $114.82 | $114.82 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $38.02 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $25.12 | Facility | 56 · Pre-op care only | $15.14 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $125.89 Typical High $1,023.29 | Professional | 52 · Reduced service | $75.86 | $125.89 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $50.12 Typical High $407.38 | Professional | 53 · Discontinued | $30.90 | $50.12 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $190.55 Typical High $1,548.82 | Professional | 54 · Surgery only | $114.82 | $190.55 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $38.02 Typical High $309.03 | Professional | 55 · Aftercare only | $22.91 | $38.02 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $25.12 Typical High $204.17 | Professional | 56 · Pre-op care only | $15.14 | $25.12 | $204.17 |
Where Wisconsin sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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
$537
WI $537MD $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.