How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,622 to $11,482Professionalmedian $1,905 · 10th to 90th $389 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 $323.59 Median $1,621.81 Typical High $14,454.40 | Facility | None | $323.59 | $1,621.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $1,621.81 Typical High $4,677.35 | Professional | None | $323.59 | $1,621.81 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $1,949.84 Typical High $8,709.64 | Professional | None | $467.74 | $1,949.84 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,623.41 | Facility | None | $3,311.31 | $3,715.35 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,380.38 Typical High $4,570.88 | Professional | None | $416.87 | $1,380.38 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $389.05 Median $2,754.23 Typical High $5,128.61 | Facility | None | $389.05 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $436.52 Median $912.01 Typical High $3,388.44 | Professional | None | $436.52 | $912.01 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $7,585.78 Typical High $11,481.54 | Facility | None | $537.03 | $7,585.78 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $4,786.30 Typical High $9,332.54 | Professional | None | $1,949.84 | $4,786.30 | $9,332.54 |
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 $616.60 Median $1,949.84 Typical High $4,073.80 | Professional | None | $616.60 | $1,949.84 | $4,073.80 |
Prevea360 Setting Facility Modifier None Typical Low $263.03 Median $537.03 Typical High $2,570.40 | Facility | None | $263.03 | $537.03 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $389.05 Median $1,348.96 Typical High $5,495.41 | Professional | None | $389.05 | $1,348.96 | $5,495.41 |
Quartz Setting Professional Modifier None Typical Low $416.87 Median $933.25 Typical High $2,570.40 | Professional | None | $416.87 | $933.25 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $7,079.46 | Professional | None | $1,258.93 | $1,258.93 | $7,079.46 |
Security Health Setting Professional Modifier None Typical Low $1,412.54 Median $5,754.40 Typical High $9,772.37 | Professional | None | $1,412.54 | $5,754.40 | $9,772.37 |
The Alliance Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,479.11 | Professional | None | $676.08 | $1,071.52 | $1,479.11 |
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 $380.19 Median $1,445.44 Typical High $6,165.95 | Professional | None | $380.19 | $1,445.44 | $6,165.95 |
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 $162.18 Median $162.18 Typical High $812.83 | Facility | 52 · Reduced service | $162.18 | $162.18 | $812.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $323.59 | Facility | 53 · Discontinued | $64.57 | $64.57 | $323.59 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $1,230.27 | Facility | 54 · Surgery only | $239.88 | $239.88 | $1,230.27 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $245.47 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $245.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $162.18 | Facility | 56 · Pre-op care only | $32.36 | $32.36 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $812.83 Typical High $2,691.53 | Professional | 52 · Reduced service | $162.18 | $812.83 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $323.59 Typical High $1,096.48 | Professional | 53 · Discontinued | $64.57 | $323.59 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $1,230.27 Typical High $4,073.80 | Professional | 54 · Surgery only | $239.88 | $1,230.27 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $245.47 Typical High $812.83 | Professional | 55 · Aftercare only | $47.86 | $245.47 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $162.18 Typical High $549.54 | Professional | 56 · Pre-op care only | $32.36 | $162.18 | $549.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $457.09 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $218.78 | $457.09 | $1,698.24 |
Where Wisconsin sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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
$2,089
WI $2,089NE $447
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.