How much rates vary
Facilitymedian $1,445 · 10th to 90th $129 to $4,266Professionalmedian $162 · 10th to 90th $59 to $389
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 $58.88 Median $1,905.46 Typical High $14,454.40 | Facility | None | $58.88 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $436.52 | Professional | None | $58.88 | $58.88 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $181.97 Typical High $389.05 | Professional | None | $44.67 | $181.97 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $173.78 | Facility | None | $50.12 | $112.20 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $245.47 | Professional | None | $83.18 | $141.25 | $245.47 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $2,818.38 Typical High $5,128.61 | Facility | None | $56.23 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $154.88 | Professional | None | $95.50 | $117.49 | $154.88 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $954.99 Typical High $1,778.28 | Facility | None | $154.88 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $169.82 Typical High $263.03 | Professional | None | $60.26 | $169.82 | $263.03 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $64.57 Median $151.36 Typical High $478.63 | Professional | None | $64.57 | $151.36 | $478.63 |
Prevea360 Setting Facility Modifier None Typical Low $40.74 Median $56.23 Typical High $154.88 | Facility | None | $40.74 | $56.23 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $117.49 Typical High $204.17 | Professional | None | $51.29 | $117.49 | $204.17 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | None | $83.18 | $83.18 | $104.71 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Security Health Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $323.59 | Professional | None | $239.88 | $295.12 | $323.59 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $57.54 Median $169.82 Typical High $251.19 | Professional | None | $57.54 | $169.82 | $251.19 |
5 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 Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $218.78 | Professional | 52 · Reduced service | $29.51 | $29.51 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $87.10 | Professional | 53 · Discontinued | $11.75 | $11.75 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $331.13 | Professional | 54 · Surgery only | $44.67 | $44.67 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $66.07 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $43.65 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $43.65 |
Where Wisconsin sits
The same service costs 6.5 times more in Tennessee than in New York. 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
$245
TN $316NY $48.98
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.