How much rates vary
Facilitymedian $10,000 · 10th to 90th $2,570 to $15,849Professionalmedian $2,630 · 10th to 90th $525 to $11,220
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 $2,630.27 Typical High $14,454.40 | Facility | None | $457.09 | $2,630.27 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $2,630.27 Typical High $8,317.64 | Professional | None | $457.09 | $2,630.27 | $8,317.64 |
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 $13,489.63 | Professional | None | $645.65 | $2,691.53 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $3,981.07 Typical High $20,892.96 | Professional | 50 · Both sides | $977.24 | $3,981.07 | $20,892.96 |
CareSource Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,187.76 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $6,025.60 Typical High $8,912.51 | Facility | None | $5,248.07 | $6,025.60 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,949.84 Typical High $7,079.46 | Professional | None | $588.84 | $1,949.84 | $7,079.46 |
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 $5,370.32 | Professional | None | $616.60 | $1,174.90 | $5,370.32 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,737.80 Typical High $8,128.31 | Professional | 50 · Both sides | $933.25 | $1,737.80 | $8,128.31 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $10,471.29 Typical High $15,135.61 | Facility | None | $676.08 | $10,471.29 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $2,511.89 Median $7,585.78 Typical High $14,454.40 | Professional | None | $2,511.89 | $7,585.78 | $14,454.40 |
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 $2,818.38 Typical High $7,244.36 | Professional | None | $977.24 | $2,818.38 | $7,244.36 |
Prevea360 Setting Facility Modifier None Typical Low $371.54 Median $741.31 Typical High $3,548.13 | Facility | None | $371.54 | $741.31 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $2,511.89 Typical High $8,317.64 | Professional | None | $549.54 | $2,511.89 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $1,288.25 Typical High $4,073.80 | Professional | None | $588.84 | $1,288.25 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $10,471.29 | Professional | None | $1,737.80 | $1,737.80 | $10,471.29 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $7,413.10 Typical High $14,125.38 | Professional | None | $1,905.46 | $7,413.10 | $14,125.38 |
The Alliance Setting Professional Modifier None Typical Low $524.81 Median $1,548.82 Typical High $2,238.72 | Professional | None | $524.81 | $1,548.82 | $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 $2,041.74 Typical High $8,511.38 | Professional | None | $512.86 | $2,041.74 | $8,511.38 |
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 $223.87 Median $223.87 Typical High $1,318.26 | Facility | 52 · Reduced service | $223.87 | $223.87 | $1,318.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $524.81 | Facility | 53 · Discontinued | $91.20 | $91.20 | $524.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $1,949.84 | Facility | 54 · Surgery only | $338.84 | $338.84 | $1,949.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $389.05 | Facility | 55 · Aftercare only | $67.61 | $67.61 | $389.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $263.03 | Facility | 56 · Pre-op care only | $45.71 | $45.71 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $1,318.26 Typical High $4,466.84 | Professional | 52 · Reduced service | $223.87 | $1,318.26 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $524.81 Typical High $1,778.28 | Professional | 53 · Discontinued | $91.20 | $524.81 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $1,949.84 Typical High $6,760.83 | Professional | 54 · Surgery only | $338.84 | $1,949.84 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $389.05 Typical High $1,348.96 | Professional | 55 · Aftercare only | $67.61 | $389.05 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $263.03 Typical High $891.25 | Professional | 56 · Pre-op care only | $45.71 | $263.03 | $891.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $588.84 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $309.03 | $588.84 | $2,691.53 |
Where Wisconsin sits
The same service costs 6.2 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
$2,951
WA $3,162MD $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.