How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $5,888Professionalmedian $1,738 · 10th to 90th $269 to $9,120
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 $190.55 Median $1,737.80 Typical High $14,454.40 | Facility | None | $190.55 | $1,737.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $1,737.80 Typical High $7,079.46 | Professional | None | $190.55 | $1,737.80 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $1,513.56 Typical High $10,964.78 | Professional | None | $346.74 | $1,513.56 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $2,290.87 Typical High $16,595.87 | Professional | 50 · Both sides | $524.81 | $2,290.87 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $4,677.35 | Facility | None | $954.99 | $2,818.38 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $2,344.23 Typical High $4,897.79 | Professional | None | $269.15 | $2,344.23 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $181.97 Median $4,365.16 Typical High $7,762.47 | Facility | None | $181.97 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $3,981.07 | Professional | None | $338.84 | $501.19 | $3,981.07 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,623.41 | Facility | None | $588.84 | $2,187.76 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $5,623.41 Typical High $9,120.11 | Professional | None | $1,995.26 | $5,623.41 | $9,120.11 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $478.63 Median $1,905.46 Typical High $7,413.10 | Professional | None | $478.63 | $1,905.46 | $7,413.10 |
Prevea360 Setting Facility Modifier None Typical Low $154.88 Median $316.23 Typical High $2,691.53 | Facility | None | $154.88 | $316.23 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $1,479.11 Typical High $5,888.44 | Professional | None | $302.00 | $1,479.11 | $5,888.44 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $3,467.37 | Facility | None | $758.58 | $2,041.74 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $2,454.71 | Professional | None | $269.15 | $512.86 | $2,454.71 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $7,943.28 | Professional | None | $758.58 | $758.58 | $7,943.28 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $6,918.31 Typical High $12,302.69 | Professional | None | $851.14 | $6,918.31 | $12,302.69 |
The Alliance Setting Professional Modifier None Typical Low $3,981.07 Median $7,585.78 Typical High $9,120.11 | Professional | None | $3,981.07 | $7,585.78 | $9,120.11 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $223.87 Median $1,348.96 Typical High $8,317.64 | Professional | None | $223.87 | $1,348.96 | $8,317.64 |
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 $95.50 Median $95.50 Typical High $870.96 | Facility | 52 · Reduced service | $95.50 | $95.50 | $870.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $346.74 | Facility | 53 · Discontinued | $38.02 | $38.02 | $346.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $1,288.25 | Facility | 54 · Surgery only | $141.25 | $141.25 | $1,288.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $257.04 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $257.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $173.78 | Facility | 56 · Pre-op care only | $19.05 | $19.05 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $870.96 Typical High $3,630.78 | Professional | 52 · Reduced service | $95.50 | $870.96 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $346.74 Typical High $1,445.44 | Professional | 53 · Discontinued | $38.02 | $346.74 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $1,288.25 Typical High $5,370.32 | Professional | 54 · Surgery only | $141.25 | $1,288.25 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $257.04 Typical High $1,096.48 | Professional | 55 · Aftercare only | $28.84 | $257.04 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $173.78 Typical High $724.44 | Professional | 56 · Pre-op care only | $19.05 | $173.78 | $724.44 |
Where Wisconsin sits
The same service costs 8.5 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
$2,291
WI $2,291NE $269
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.