How much rates vary
Facilitymedian $1,445 · 10th to 90th $234 to $3,090Professionalmedian $813 · 10th to 90th $191 to $3,236
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 $158.49 Median $724.44 Typical High $14,454.40 | Facility | None | $158.49 | $724.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $724.44 Typical High $3,090.30 | Professional | None | $158.49 | $724.44 | $3,090.30 |
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 $223.87 Median $831.76 Typical High $3,801.89 | Professional | None | $223.87 | $831.76 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,454.71 | Facility | None | $1,445.44 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $1,995.26 | Professional | None | $204.17 | $562.34 | $1,995.26 |
DeanCare Setting Facility Modifier None Typical Low $186.21 Median $2,754.23 Typical High $5,128.61 | Facility | None | $186.21 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $1,479.11 | Professional | None | $218.78 | $416.87 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,318.26 Typical High $1,778.28 | Facility | None | $234.42 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $2,041.74 Typical High $3,981.07 | Professional | None | $645.65 | $2,041.74 | $3,981.07 |
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 $295.12 Median $812.83 Typical High $1,621.81 | Professional | None | $295.12 | $812.83 | $1,621.81 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $257.04 Typical High $977.24 | Facility | None | $128.82 | $257.04 | $977.24 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $602.56 Typical High $2,187.76 | Professional | None | $186.21 | $602.56 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $1,122.02 | Professional | None | $204.17 | $457.09 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $3,019.95 | Professional | None | $630.96 | $630.96 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $4,073.80 | Professional | None | $630.96 | $954.99 | $4,073.80 |
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 $181.97 Median $645.65 Typical High $2,398.83 | Professional | None | $181.97 | $645.65 | $2,398.83 |
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 $79.43 Median $79.43 Typical High $363.08 | Facility | 52 · Reduced service | $79.43 | $79.43 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $144.54 | Facility | 53 · Discontinued | $31.62 | $31.62 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $537.03 | Facility | 54 · Surgery only | $117.49 | $117.49 | $537.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $107.15 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $107.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $72.44 | Facility | 56 · Pre-op care only | $15.85 | $15.85 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $363.08 Typical High $1,548.82 | Professional | 52 · Reduced service | $79.43 | $363.08 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $144.54 Typical High $616.60 | Professional | 53 · Discontinued | $31.62 | $144.54 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $537.03 Typical High $2,344.23 | Professional | 54 · Surgery only | $117.49 | $537.03 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $107.15 Typical High $467.74 | Professional | 55 · Aftercare only | $23.44 | $107.15 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $72.44 Typical High $309.03 | Professional | 56 · Pre-op care only | $15.85 | $72.44 | $309.03 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $208.93 Typical High $741.31 | Professional | 51 · Multiple procedures | $107.15 | $208.93 | $741.31 |
Where Wisconsin sits
The same service costs 4.0 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
$851
WI $851MD $214
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.