How much rates vary
Facilitymedian $933 · 10th to 90th $151 to $2,344Professionalmedian $468 · 10th to 90th $141 to $1,738
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 $112.20 Median $323.59 Typical High $14,454.40 | Facility | None | $112.20 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $323.59 Typical High $3,467.37 | Professional | None | $112.20 | $323.59 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $588.84 Typical High $1,862.09 | Professional | None | $162.18 | $588.84 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $891.25 Typical High $2,818.38 | Professional | 50 · Both sides | $239.88 | $891.25 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $758.58 Typical High $1,348.96 | Facility | None | $645.65 | $758.58 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $446.68 Typical High $891.25 | Professional | None | $158.49 | $446.68 | $891.25 |
DeanCare Setting Facility Modifier None Typical Low $107.15 Median $2,630.27 Typical High $5,128.61 | Facility | None | $107.15 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $758.58 | Professional | None | $199.53 | $295.12 | $758.58 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $912.01 Typical High $1,778.28 | Facility | None | $151.36 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $954.99 Typical High $1,479.11 | Professional | None | $338.84 | $954.99 | $1,479.11 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $891.25 | Professional | None | $245.47 | $389.05 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $186.21 Typical High $501.19 | Facility | None | $91.20 | $186.21 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $354.81 Typical High $1,071.52 | Professional | None | $173.78 | $354.81 | $1,071.52 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $457.09 | Professional | None | $158.49 | $295.12 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $1,380.38 | Professional | None | $436.52 | $436.52 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,089.30 | Professional | None | $549.54 | $1,348.96 | $2,089.30 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $407.38 Typical High $1,412.54 | Professional | None | $128.82 | $407.38 | $1,412.54 |
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 $56.23 Median $56.23 Typical High $162.18 | Facility | 52 · Reduced service | $56.23 | $56.23 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $64.57 | Facility | 53 · Discontinued | $22.39 | $22.39 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $245.47 | Facility | 54 · Surgery only | $85.11 | $85.11 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $48.98 | Facility | 55 · Aftercare only | $16.98 | $16.98 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $32.36 | Facility | 56 · Pre-op care only | $11.22 | $11.22 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $162.18 Typical High $1,737.80 | Professional | 52 · Reduced service | $56.23 | $162.18 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $64.57 Typical High $691.83 | Professional | 53 · Discontinued | $22.39 | $64.57 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $245.47 Typical High $2,570.40 | Professional | 54 · Surgery only | $85.11 | $245.47 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $48.98 Typical High $512.86 | Professional | 55 · Aftercare only | $16.98 | $48.98 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $32.36 Typical High $346.74 | Professional | 56 · Pre-op care only | $11.22 | $32.36 | $346.74 |
Where Wisconsin sits
The same service costs 3.6 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
$537
WI $537NE $148
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.