How much rates vary
Facilitymedian $3,020 · 10th to 90th $229 to $8,710Professionalmedian $257 · 10th to 90th $100 to $513
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 $100.00 Median $1,905.46 Typical High $14,454.40 | Facility | None | $100.00 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $1,412.54 | Professional | None | $100.00 | $100.00 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $4,365.16 Typical High $7,079.46 | Facility | None | $2,344.23 | $4,365.16 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $302.00 Typical High $537.03 | Professional | None | $97.72 | $302.00 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $1,584.89 | Facility | None | $204.17 | $269.15 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $389.05 | Professional | None | $107.15 | $169.82 | $389.05 |
DeanCare Setting Facility Modifier None Typical Low $95.50 Median $2,818.38 Typical High $5,128.61 | Facility | None | $95.50 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $257.04 | Professional | None | $138.04 | $204.17 | $257.04 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $2,187.76 Typical High $18,197.01 | Facility | None | $190.55 | $2,187.76 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $263.03 Typical High $549.54 | Professional | None | $93.33 | $263.03 | $549.54 |
Network Health Setting Facility Modifier None Typical Low $114.82 Median $186.21 Typical High $2,089.30 | Facility | None | $114.82 | $186.21 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $295.12 | Professional | None | $114.82 | $218.78 | $295.12 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $186.21 | Facility | None | $70.79 | $95.50 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $338.84 | Professional | None | $77.62 | $177.83 | $338.84 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $257.04 | Professional | None | $107.15 | $107.15 | $257.04 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $426.58 Typical High $467.74 | Professional | None | $194.98 | $426.58 | $467.74 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $81.28 Median $257.04 Typical High $446.68 | Professional | None | $81.28 | $257.04 | $446.68 |
5 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 Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $707.95 | Professional | 52 · Reduced service | $50.12 | $50.12 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $281.84 | Professional | 53 · Discontinued | $19.95 | $19.95 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $1,071.52 | Professional | 54 · Surgery only | $75.86 | $75.86 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $213.80 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $141.25 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $141.25 |
Where Wisconsin sits
The same service costs 6.5 times more in Tennessee 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
$339
TN $513NY $79.43
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.