How much rates vary
Facilitymedian $8,913 · 10th to 90th $2,570 to $15,849Professionalmedian $2,818 · 10th to 90th $550 to $12,303
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 $2,570.40 Typical High $14,454.40 | Facility | None | $457.09 | $2,570.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $2,570.40 Typical High $7,079.46 | Professional | None | $457.09 | $2,570.40 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $16,982.44 | Facility | None | $5,754.40 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $2,884.03 Typical High $13,489.63 | Professional | None | $660.69 | $2,884.03 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $5,888.44 Typical High $8,912.51 | Facility | None | $5,248.07 | $5,888.44 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $2,290.87 Typical High $7,244.36 | Professional | None | $588.84 | $2,290.87 | $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 $630.96 Median $1,288.25 Typical High $5,370.32 | Professional | None | $630.96 | $1,288.25 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $10,471.29 Typical High $15,135.61 | Facility | None | $741.31 | $10,471.29 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $14,454.40 | Professional | None | $3,090.30 | $7,413.10 | $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 $870.96 Median $3,090.30 Typical High $6,165.95 | Professional | None | $870.96 | $3,090.30 | $6,165.95 |
Prevea360 Setting Facility Modifier None Typical Low $380.19 Median $741.31 Typical High $4,073.80 | Facility | None | $380.19 | $741.31 | $4,073.80 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $2,089.30 Typical High $8,511.38 | Professional | None | $537.03 | $2,089.30 | $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 $1,778.28 Median $1,778.28 Typical High $10,964.78 | Professional | None | $1,778.28 | $1,778.28 | $10,964.78 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $9,332.54 Typical High $15,488.17 | Professional | None | $1,995.26 | $9,332.54 | $15,488.17 |
The Alliance Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,630.27 | Professional | None | $912.01 | $1,445.44 | $2,630.27 |
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 $537.03 Median $2,187.76 Typical High $9,772.37 | Professional | None | $537.03 | $2,187.76 | $9,772.37 |
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 $1,288.25 | Facility | 52 · Reduced service | $229.09 | $229.09 | $1,288.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $512.86 | Facility | 53 · Discontinued | $91.20 | $91.20 | $512.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $1,949.84 | Facility | 54 · Surgery only | $346.74 | $346.74 | $1,949.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $389.05 | Facility | 55 · Aftercare only | $69.18 | $69.18 | $389.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $257.04 | Facility | 56 · Pre-op care only | $45.71 | $45.71 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $1,288.25 Typical High $3,548.13 | Professional | 52 · Reduced service | $229.09 | $1,288.25 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $512.86 Typical High $1,412.54 | Professional | 53 · Discontinued | $91.20 | $512.86 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $1,949.84 Typical High $5,248.07 | Professional | 54 · Surgery only | $346.74 | $1,949.84 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $389.05 Typical High $1,047.13 | Professional | 55 · Aftercare only | $69.18 | $389.05 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $257.04 Typical High $707.95 | Professional | 56 · Pre-op care only | $45.71 | $257.04 | $707.95 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $645.65 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $316.23 | $645.65 | $2,691.53 |
Where Wisconsin sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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
$3,162
WI $3,162HI $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.