How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,585 to $11,482Professionalmedian $1,862 · 10th to 90th $427 to $7,079
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 $354.81 Median $1,584.89 Typical High $14,454.40 | Facility | None | $354.81 | $1,584.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,584.89 Typical High $4,570.88 | Professional | None | $354.81 | $1,584.89 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $1,949.84 Typical High $8,317.64 | Professional | None | $512.86 | $1,949.84 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $2,951.21 Typical High $12,589.25 | Professional | 50 · Both sides | $758.58 | $2,951.21 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $5,370.32 | Facility | None | $3,235.94 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,318.26 Typical High $4,265.80 | Professional | None | $457.09 | $1,318.26 | $4,265.80 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $2,754.23 Typical High $5,128.61 | Facility | None | $416.87 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $489.78 Median $954.99 Typical High $3,311.31 | Professional | None | $489.78 | $954.99 | $3,311.31 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,412.54 Typical High $4,897.79 | Professional | 50 · Both sides | $724.44 | $1,412.54 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $7,585.78 Typical High $11,481.54 | Facility | None | $588.84 | $7,585.78 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $4,677.35 Typical High $8,912.51 | Professional | None | $1,778.28 | $4,677.35 | $8,912.51 |
Network Health Setting Facility Modifier None Typical Low $7,762.47 Median $8,317.64 Typical High $9,120.11 | Facility | None | $7,762.47 | $8,317.64 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $776.25 Median $1,778.28 Typical High $4,466.84 | Professional | None | $776.25 | $1,778.28 | $4,466.84 |
Prevea360 Setting Facility Modifier None Typical Low $288.40 Median $588.84 Typical High $2,290.87 | Facility | None | $288.40 | $588.84 | $2,290.87 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $1,412.54 Typical High $5,248.07 | Professional | None | $426.58 | $1,412.54 | $5,248.07 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $1,023.29 Typical High $2,454.71 | Professional | None | $457.09 | $1,023.29 | $2,454.71 |
Security Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $6,456.54 | Professional | None | $1,380.38 | $1,380.38 | $6,456.54 |
Security Health Setting Professional Modifier None Typical Low $1,548.82 Median $5,011.87 Typical High $8,912.51 | Professional | None | $1,548.82 | $5,011.87 | $8,912.51 |
The Alliance Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $6,309.57 Median $10,232.93 Typical High $12,022.64 | Facility | None | $6,309.57 | $10,232.93 | $12,022.64 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,513.56 Typical High $5,370.32 | Professional | None | $407.38 | $1,513.56 | $5,370.32 |
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 $177.83 Median $177.83 Typical High $794.33 | Facility | 52 · Reduced service | $177.83 | $177.83 | $794.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $316.23 | Facility | 53 · Discontinued | $70.79 | $70.79 | $316.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $1,202.26 | Facility | 54 · Surgery only | $263.03 | $263.03 | $1,202.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $239.88 | Facility | 55 · Aftercare only | $53.70 | $53.70 | $239.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $158.49 | Facility | 56 · Pre-op care only | $35.48 | $35.48 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $794.33 Typical High $2,691.53 | Professional | 52 · Reduced service | $177.83 | $794.33 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $316.23 Typical High $1,071.52 | Professional | 53 · Discontinued | $70.79 | $316.23 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,202.26 Typical High $3,981.07 | Professional | 54 · Surgery only | $263.03 | $1,202.26 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $239.88 Typical High $794.33 | Professional | 55 · Aftercare only | $53.70 | $239.88 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $158.49 Typical High $537.03 | Professional | 56 · Pre-op care only | $35.48 | $158.49 | $537.03 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $478.63 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $245.47 | $478.63 | $1,621.81 |
Where Wisconsin sits
The same service costs 5.1 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
$2,042
WI $2,042MD $398
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.