How much rates vary
Facilitymedian $10,000 · 10th to 90th $2,455 to $15,849Professionalmedian $2,692 · 10th to 90th $525 to $11,749
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 $457.09 Median $2,691.53 Typical High $14,454.40 | Facility | None | $457.09 | $2,691.53 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $2,691.53 Typical High $8,128.31 | Professional | None | $457.09 | $2,691.53 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $11,220.18 Typical High $16,982.44 | Facility | None | $6,456.54 | $11,220.18 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $2,691.53 Typical High $14,125.38 | Professional | None | $645.65 | $2,691.53 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $4,073.80 Typical High $21,379.62 | Professional | 50 · Both sides | $977.24 | $4,073.80 | $21,379.62 |
CareSource Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,238.72 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $9,120.11 | Facility | None | $5,370.32 | $6,165.95 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $2,041.74 Typical High $7,244.36 | Professional | None | $588.84 | $2,041.74 | $7,244.36 |
DeanCare Setting Facility Modifier None Typical Low $537.03 Median $2,818.38 Typical High $5,128.61 | Facility | None | $537.03 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $616.60 Median $1,174.90 Typical High $5,495.41 | Professional | None | $616.60 | $1,174.90 | $5,495.41 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,778.28 Typical High $8,317.64 | Professional | 50 · Both sides | $933.25 | $1,778.28 | $8,317.64 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $10,232.93 Typical High $15,135.61 | Facility | None | $758.58 | $10,232.93 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $2,630.27 Median $7,762.47 Typical High $14,791.08 | Professional | None | $2,630.27 | $7,762.47 | $14,791.08 |
Network Health Setting Facility Modifier None Typical Low $9,772.37 Median $10,964.78 Typical High $17,378.01 | Facility | None | $9,772.37 | $10,964.78 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $977.24 Median $2,951.21 Typical High $7,413.10 | Professional | None | $977.24 | $2,951.21 | $7,413.10 |
Prevea360 Setting Facility Modifier None Typical Low $371.54 Median $758.58 Typical High $3,801.89 | Facility | None | $371.54 | $758.58 | $3,801.89 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $2,630.27 Typical High $8,511.38 | Professional | None | $549.54 | $2,630.27 | $8,511.38 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $1,318.26 Typical High $4,073.80 | Professional | None | $588.84 | $1,318.26 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $10,715.19 | Professional | None | $1,737.80 | $1,737.80 | $10,715.19 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $7,943.28 Typical High $14,791.08 | Professional | None | $1,905.46 | $7,943.28 | $14,791.08 |
The Alliance Setting Professional Modifier None Typical Low $524.81 Median $1,584.89 Typical High $2,238.72 | Professional | None | $524.81 | $1,584.89 | $2,238.72 |
United Setting Facility Modifier None Typical Low $8,912.51 Median $14,454.40 Typical High $16,595.87 | Facility | None | $8,912.51 | $14,454.40 | $16,595.87 |
United Setting Professional Modifier None Typical Low $512.86 Median $2,137.96 Typical High $8,912.51 | Professional | None | $512.86 | $2,137.96 | $8,912.51 |
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 $229.09 Median $229.09 Typical High $1,348.96 | Facility | 52 · Reduced service | $229.09 | $229.09 | $1,348.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $537.03 | Facility | 53 · Discontinued | $91.20 | $91.20 | $537.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $1,995.26 | Facility | 54 · Surgery only | $338.84 | $338.84 | $1,995.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $398.11 | Facility | 55 · Aftercare only | $67.61 | $67.61 | $398.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $269.15 | Facility | 56 · Pre-op care only | $45.71 | $45.71 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $1,348.96 Typical High $4,786.30 | Professional | 52 · Reduced service | $229.09 | $1,348.96 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $537.03 Typical High $1,905.46 | Professional | 53 · Discontinued | $91.20 | $537.03 | $1,905.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $1,995.26 Typical High $7,079.46 | Professional | 54 · Surgery only | $338.84 | $1,995.26 | $7,079.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $398.11 Typical High $1,412.54 | Professional | 55 · Aftercare only | $67.61 | $398.11 | $1,412.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $269.15 Typical High $954.99 | Professional | 56 · Pre-op care only | $45.71 | $269.15 | $954.99 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $588.84 Typical High $2,754.23 | Professional | 51 · Multiple procedures | $309.03 | $588.84 | $2,754.23 |
Where Wisconsin sits
The same service costs 6.3 times more in Washington 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· 2nd of 51
$3,020
WA $3,236MD $513
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.