How much rates vary
Facilitymedian $5,495 · 10th to 90th $575 to $11,220Professionalmedian $417 · 10th to 90th $158 to $912
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 $158.49 Median $1,905.46 Typical High $14,454.40 | Facility | None | $158.49 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $1,348.96 | Professional | None | $158.49 | $158.49 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,762.47 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,762.47 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $467.74 Typical High $912.01 | Professional | None | $141.25 | $467.74 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $831.76 Typical High $5,128.61 | Facility | None | $309.03 | $831.76 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $660.69 | Professional | None | $223.87 | $371.54 | $660.69 |
DeanCare Setting Facility Modifier None Typical Low $147.91 Median $2,754.23 Typical High $5,128.61 | Facility | None | $147.91 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $371.54 | Professional | None | $251.19 | $309.03 | $371.54 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $5,623.41 Typical High $10,964.78 | Facility | None | $741.31 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $416.87 Typical High $676.08 | Professional | None | $147.91 | $416.87 | $676.08 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $398.11 | Professional | None | $173.78 | $295.12 | $398.11 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $173.78 Typical High $575.44 | Facility | None | $128.82 | $173.78 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $257.04 Typical High $524.81 | Professional | None | $112.20 | $257.04 | $524.81 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $3,467.37 Typical High $5,623.41 | Facility | None | $630.96 | $3,467.37 | $5,623.41 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
Security Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $851.14 | Professional | None | $562.34 | $741.31 | $851.14 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $138.04 Median $416.87 Typical High $645.65 | Professional | None | $138.04 | $416.87 | $645.65 |
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 $79.43 Median $79.43 Typical High $676.08 | Professional | 52 · Reduced service | $79.43 | $79.43 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $275.42 | Professional | 53 · Discontinued | $31.62 | $31.62 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $1,023.29 | Professional | 54 · Surgery only | $117.49 | $117.49 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $204.17 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $134.90 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $134.90 |
Where Wisconsin sits
The same service costs 12.9 times more in Arkansas 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· 11th of 51
$646
AR $1,585NY $123
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.