How much rates vary
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,819.70 | $1,819.70 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,511.89 Typical High $3,801.89 | Facility | None | $812.83 | $2,511.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,698.24 | $1,949.84 | $2,511.89 |
DeanCare Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $14,791.08 | Facility | None | $6,165.95 | $8,128.31 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $2,454.71 Typical High $18,197.01 | Facility | None | $426.58 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 |
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 |
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 $891.25 Median $891.25 Typical High $1,778.28 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $707.95 | Professional | 53 · Discontinued | $363.08 | $363.08 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $537.03 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $354.81 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $354.81 |
Where Wisconsin sits
The same service costs 158.5 times more in Colorado than in Hawaii. 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
$4,677
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.