How much rates vary
Facilitymedian $1,445 · 10th to 90th $110 to $4,266Professionalmedian $141 · 10th to 90th $51 to $282
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 $51.29 Median $1,905.46 Typical High $14,454.40 | Facility | None | $51.29 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $218.78 | Professional | None | $51.29 | $51.29 | $218.78 |
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 $38.90 Median $162.18 Typical High $331.13 | Professional | None | $38.90 | $162.18 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $151.36 | Facility | None | $50.12 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $213.80 | Professional | None | $72.44 | $123.03 | $213.80 |
DeanCare Setting Facility Modifier None Typical Low $44.67 Median $2,818.38 Typical High $5,128.61 | Facility | None | $44.67 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $131.83 | Professional | None | $81.28 | $100.00 | $131.83 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $1,000.00 Typical High $1,778.28 | Facility | None | $151.36 | $1,000.00 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $141.25 Typical High $295.12 | Professional | None | $50.12 | $141.25 | $295.12 |
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 $56.23 Median $114.82 Typical High $281.84 | Professional | None | $56.23 | $114.82 | $281.84 |
Prevea360 Setting Facility Modifier None Typical Low $34.67 Median $48.98 Typical High $81.28 | Facility | None | $34.67 | $48.98 | $81.28 |
Quartz Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $177.83 | Professional | None | $36.31 | $85.11 | $177.83 |
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 $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
Security Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Security Health Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $288.40 | Professional | None | $190.55 | $257.04 | $288.40 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,174.90 Typical High $1,862.09 | Facility | None | $218.78 | $1,174.90 | $1,862.09 |
United Setting Professional Modifier None Typical Low $47.86 Median $141.25 Typical High $218.78 | Professional | None | $47.86 | $141.25 | $218.78 |
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 $25.70 Median $25.70 Typical High $109.65 | Professional | 52 · Reduced service | $25.70 | $25.70 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $43.65 | Professional | 53 · Discontinued | $10.23 | $10.23 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $162.18 | Professional | 54 · Surgery only | $38.02 | $38.02 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $32.36 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $21.88 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $21.88 |
Where Wisconsin sits
The same service costs 9.3 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· 3rd of 51
$209
TN $398NY $42.66
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.