How much rates vary
Facilitymedian $1,445 · 10th to 90th $282 to $2,818Professionalmedian $891 · 10th to 90th $229 to $3,388
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 $186.21 Median $691.83 Typical High $14,454.40 | Facility | None | $186.21 | $691.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $691.83 Typical High $3,548.13 | Professional | None | $186.21 | $691.83 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $1,000.00 Typical High $3,630.78 | Professional | None | $275.42 | $1,000.00 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $1,479.11 Typical High $5,495.41 | Professional | 50 · Both sides | $416.87 | $1,479.11 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,398.83 | Facility | None | $1,412.54 | $1,584.89 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $1,819.70 | Professional | None | $245.47 | $562.34 | $1,819.70 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $2,754.23 Typical High $5,128.61 | Facility | None | $229.09 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $524.81 Typical High $1,445.44 | Professional | None | $257.04 | $524.81 | $1,445.44 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $794.33 Typical High $2,137.96 | Professional | 50 · Both sides | $389.05 | $794.33 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $1,318.26 Typical High $1,778.28 | Facility | None | $281.84 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,890.45 | Professional | None | $616.60 | $2,041.74 | $3,890.45 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,344.23 | Facility | None | $831.76 | $1,819.70 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $363.08 Median $831.76 Typical High $1,584.89 | Professional | None | $363.08 | $831.76 | $1,584.89 |
Prevea360 Setting Facility Modifier None Typical Low $154.88 Median $323.59 Typical High $1,000.00 | Facility | None | $154.88 | $323.59 | $1,000.00 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $645.65 Typical High $2,137.96 | Professional | None | $229.09 | $645.65 | $2,137.96 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $1,096.48 | Professional | None | $245.47 | $501.19 | $1,096.48 |
Security Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,884.03 | Professional | None | $741.31 | $741.31 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $1,995.26 Typical High $4,168.69 | Professional | None | $851.14 | $1,995.26 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $218.78 Median $660.69 Typical High $2,238.72 | Professional | None | $218.78 | $660.69 | $2,238.72 |
11 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 $93.33 Median $93.33 Typical High $346.74 | Facility | 52 · Reduced service | $93.33 | $93.33 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $138.04 | Facility | 53 · Discontinued | $38.02 | $38.02 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $524.81 | Facility | 54 · Surgery only | $141.25 | $141.25 | $524.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $104.71 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $69.18 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $346.74 Typical High $1,778.28 | Professional | 52 · Reduced service | $93.33 | $346.74 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $138.04 Typical High $707.95 | Professional | 53 · Discontinued | $38.02 | $138.04 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $524.81 Typical High $2,691.53 | Professional | 54 · Surgery only | $141.25 | $524.81 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $104.71 Typical High $537.03 | Professional | 55 · Aftercare only | $28.18 | $104.71 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $69.18 Typical High $354.81 | Professional | 56 · Pre-op care only | $18.62 | $69.18 | $354.81 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $263.03 Typical High $724.44 | Professional | 51 · Multiple procedures | $128.82 | $263.03 | $724.44 |
Where Wisconsin sits
The same service costs 3.5 times more in Wisconsin than in Nebraska. 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
$912
WI $912NE $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.