How much rates vary
Facilitymedian $1,660 · 10th to 90th $457 to $3,802Professionalmedian $1,698 · 10th to 90th $347 to $7,586
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 $309.03 Median $1,698.24 Typical High $14,454.40 | Facility | None | $309.03 | $1,698.24 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,698.24 Typical High $5,623.41 | Professional | None | $309.03 | $1,698.24 | $5,623.41 |
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 $436.52 Median $1,819.70 Typical High $9,120.11 | Professional | None | $436.52 | $1,819.70 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $2,691.53 Typical High $13,489.63 | Professional | 50 · Both sides | $645.65 | $2,691.53 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,981.07 Typical High $5,888.44 | Facility | None | $3,467.37 | $3,981.07 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,412.54 Typical High $4,466.84 | Professional | None | $398.11 | $1,412.54 | $4,466.84 |
DeanCare Setting Facility Modifier None Typical Low $363.08 Median $2,754.23 Typical High $5,128.61 | Facility | None | $363.08 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $3,548.13 | Professional | None | $416.87 | $794.33 | $3,548.13 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $1,202.26 Typical High $5,370.32 | Professional | 50 · Both sides | $630.96 | $1,202.26 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $1,445.44 Typical High $2,089.30 | Facility | None | $457.09 | $1,445.44 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $9,332.54 | Professional | None | $1,737.80 | $4,897.79 | $9,332.54 |
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 $660.69 Median $1,862.09 Typical High $4,570.88 | Professional | None | $660.69 | $1,862.09 | $4,570.88 |
Prevea360 Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $2,511.89 | Facility | None | $251.19 | $501.19 | $2,511.89 |
Quartz Setting Professional Modifier None Typical Low $354.81 Median $1,698.24 Typical High $5,495.41 | Professional | None | $354.81 | $1,698.24 | $5,495.41 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $870.96 Typical High $2,691.53 | Professional | None | $398.11 | $870.96 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $6,606.93 | Professional | None | $1,174.90 | $1,174.90 | $6,606.93 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $5,370.32 Typical High $9,332.54 | Professional | None | $1,258.93 | $5,370.32 | $9,332.54 |
The Alliance Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
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 $346.74 Median $1,380.38 Typical High $5,754.40 | Professional | None | $346.74 | $1,380.38 | $5,754.40 |
10 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 $151.36 Median $151.36 Typical High $851.14 | Facility | 52 · Reduced service | $151.36 | $151.36 | $851.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $346.74 | Facility | 53 · Discontinued | $61.66 | $61.66 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $1,288.25 | Facility | 54 · Surgery only | $229.09 | $229.09 | $1,288.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $257.04 | Facility | 55 · Aftercare only | $45.71 | $45.71 | $257.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $169.82 | Facility | 56 · Pre-op care only | $30.90 | $30.90 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $851.14 Typical High $3,311.31 | Professional | 52 · Reduced service | $151.36 | $851.14 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $346.74 Typical High $1,318.26 | Professional | 53 · Discontinued | $61.66 | $346.74 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $1,288.25 Typical High $4,897.79 | Professional | 54 · Surgery only | $229.09 | $1,288.25 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $257.04 Typical High $1,000.00 | Professional | 55 · Aftercare only | $45.71 | $257.04 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $169.82 Typical High $660.69 | Professional | 56 · Pre-op care only | $30.90 | $169.82 | $660.69 |
Where Wisconsin sits
The same service costs 6.5 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· 5th of 51
$1,698
WA $2,138MD $331
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.