How much rates vary
Facilitymedian $7,762 · 10th to 90th $2,089 to $11,482Professionalmedian $2,188 · 10th to 90th $479 to $9,333
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 $407.38 Median $2,089.30 Typical High $14,454.40 | Facility | None | $407.38 | $2,089.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,089.30 Typical High $7,413.10 | Professional | None | $407.38 | $2,089.30 | $7,413.10 |
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 $575.44 Median $2,238.72 Typical High $10,715.19 | Professional | None | $575.44 | $2,238.72 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $3,388.44 Typical High $16,595.87 | Professional | 50 · Both sides | $870.96 | $3,388.44 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $7,244.36 | Facility | None | $4,265.80 | $4,786.30 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,584.89 Typical High $5,495.41 | Professional | None | $524.81 | $1,584.89 | $5,495.41 |
DeanCare Setting Facility Modifier None Typical Low $478.63 Median $2,818.38 Typical High $5,128.61 | Facility | None | $478.63 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $4,365.16 | Professional | None | $549.54 | $1,047.13 | $4,365.16 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,548.82 Typical High $6,456.54 | Professional | 50 · Both sides | $831.76 | $1,548.82 | $6,456.54 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $7,585.78 Typical High $11,481.54 | Facility | None | $660.69 | $7,585.78 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $2,089.30 Median $6,025.60 Typical High $11,481.54 | Professional | None | $2,089.30 | $6,025.60 | $11,481.54 |
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 $851.14 Median $2,187.76 Typical High $5,623.41 | Professional | None | $851.14 | $2,187.76 | $5,623.41 |
Prevea360 Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $2,818.38 | Facility | None | $331.13 | $660.69 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $1,995.26 Typical High $6,456.54 | Professional | None | $489.78 | $1,995.26 | $6,456.54 |
Quartz Setting Professional Modifier None Typical Low $524.81 Median $1,174.90 Typical High $3,235.94 | Professional | None | $524.81 | $1,174.90 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $8,128.31 | Professional | None | $1,548.82 | $1,548.82 | $8,128.31 |
Security Health Setting Professional Modifier None Typical Low $1,698.24 Median $5,888.44 Typical High $11,220.18 | Professional | None | $1,698.24 | $5,888.44 | $11,220.18 |
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 $457.09 Median $1,737.80 Typical High $6,606.93 | Professional | None | $457.09 | $1,737.80 | $6,606.93 |
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 $204.17 Median $204.17 Typical High $1,047.13 | Facility | 52 · Reduced service | $204.17 | $204.17 | $1,047.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $416.87 | Facility | 53 · Discontinued | $81.28 | $81.28 | $416.87 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $1,548.82 | Facility | 54 · Surgery only | $302.00 | $302.00 | $1,548.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $316.23 | Facility | 55 · Aftercare only | $60.26 | $60.26 | $316.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $208.93 | Facility | 56 · Pre-op care only | $40.74 | $40.74 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $1,047.13 Typical High $4,265.80 | Professional | 52 · Reduced service | $204.17 | $1,047.13 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $416.87 Typical High $1,737.80 | Professional | 53 · Discontinued | $81.28 | $416.87 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,548.82 Typical High $6,456.54 | Professional | 54 · Surgery only | $302.00 | $1,548.82 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $316.23 Typical High $1,288.25 | Professional | 55 · Aftercare only | $60.26 | $316.23 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $208.93 Typical High $870.96 | Professional | 56 · Pre-op care only | $40.74 | $208.93 | $870.96 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $512.86 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $275.42 | $512.86 | $2,137.96 |
Where Wisconsin sits
The same service costs 5.6 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
$2,570
WI $2,570MD $457
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.