How much rates vary
Facilitymedian $1,514 · 10th to 90th $257 to $3,090Professionalmedian $891 · 10th to 90th $204 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 $173.78 Median $741.31 Typical High $14,454.40 | Facility | None | $173.78 | $741.31 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $741.31 Typical High $2,344.23 | Professional | None | $173.78 | $741.31 | $2,344.23 |
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 $295.12 Median $954.99 Typical High $3,981.07 | Professional | None | $295.12 | $954.99 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $1,445.44 Typical High $5,888.44 | Professional | 50 · Both sides | $371.54 | $1,445.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,570.40 | Facility | None | $1,513.56 | $1,698.24 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $645.65 Typical High $2,089.30 | Professional | None | $223.87 | $645.65 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $2,754.23 Typical High $5,128.61 | Facility | None | $204.17 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $234.42 Median $512.86 Typical High $1,548.82 | Professional | None | $234.42 | $512.86 | $1,548.82 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $758.58 Typical High $2,344.23 | Professional | 50 · Both sides | $354.81 | $758.58 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $1,318.26 Typical High $1,778.28 | Facility | None | $257.04 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $2,187.76 Typical High $4,265.80 | Professional | None | $758.58 | $2,187.76 | $4,265.80 |
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 $346.74 Median $870.96 Typical High $1,862.09 | Professional | None | $346.74 | $870.96 | $1,862.09 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $288.40 Typical High $1,096.48 | Facility | None | $141.25 | $288.40 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $630.96 Typical High $2,454.71 | Professional | None | $208.93 | $630.96 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $457.09 Typical High $1,174.90 | Professional | None | $223.87 | $457.09 | $1,174.90 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $3,235.94 | Professional | None | $676.08 | $676.08 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $4,365.16 | Professional | None | $691.83 | $1,047.13 | $4,365.16 |
The Alliance Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | None | $794.33 | $794.33 | $977.24 |
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 $204.17 Median $741.31 Typical High $2,570.40 | Professional | None | $204.17 | $741.31 | $2,570.40 |
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 $87.10 Median $87.10 Typical High $371.54 | Facility | 52 · Reduced service | $87.10 | $87.10 | $371.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $151.36 | Facility | 53 · Discontinued | $34.67 | $34.67 | $151.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $562.34 | Facility | 54 · Surgery only | $128.82 | $128.82 | $562.34 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $112.20 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $74.13 | Facility | 56 · Pre-op care only | $17.38 | $17.38 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $371.54 Typical High $1,380.38 | Professional | 52 · Reduced service | $87.10 | $371.54 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $151.36 Typical High $562.34 | Professional | 53 · Discontinued | $34.67 | $151.36 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $562.34 Typical High $2,089.30 | Professional | 54 · Surgery only | $128.82 | $562.34 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $112.20 Typical High $416.87 | Professional | 55 · Aftercare only | $25.70 | $112.20 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $74.13 Typical High $275.42 | Professional | 56 · Pre-op care only | $17.38 | $74.13 | $275.42 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $257.04 Typical High $776.25 | Professional | 51 · Multiple procedures | $117.49 | $257.04 | $776.25 |
Where Wisconsin sits
The same service costs 3.8 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 $240
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.