How much rates vary
Facilitymedian $7,943 · 10th to 90th $759 to $15,136Professionalmedian $427 · 10th to 90th $158 to $955
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 $6,456.54 Typical High $14,454.40 | Facility | None | $158.49 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $1,621.81 | Professional | None | $158.49 | $158.49 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $478.63 Typical High $954.99 | Professional | None | $138.04 | $478.63 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,202.26 Typical High $7,943.28 | Facility | None | $302.00 | $1,202.26 | $7,943.28 |
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 $151.36 Median $4,365.16 Typical High $7,762.47 | Facility | None | $151.36 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $407.38 | Professional | None | $251.19 | $309.03 | $407.38 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $7,943.28 Typical High $16,595.87 | Facility | None | $933.25 | $7,943.28 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $457.09 Typical High $707.95 | Professional | None | $177.83 | $457.09 | $707.95 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $512.86 | Professional | None | $173.78 | $346.74 | $512.86 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $933.25 | Facility | None | $128.82 | $186.21 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $537.03 | Professional | None | $120.23 | $275.42 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $8,709.64 | Facility | None | $758.58 | $5,370.32 | $8,709.64 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | None | $223.87 | $223.87 | $269.15 |
Security Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $933.25 | Professional | None | $575.44 | $812.83 | $933.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $141.25 Median $436.52 Typical High $676.08 | Professional | None | $141.25 | $436.52 | $676.08 |
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 $812.83 | Professional | 52 · Reduced service | $79.43 | $79.43 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $323.59 | Professional | 53 · Discontinued | $31.62 | $31.62 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $1,230.27 | Professional | 54 · Surgery only | $117.49 | $117.49 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $245.47 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $162.18 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $162.18 |
Where Wisconsin sits
The same service costs 24.1 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $8,887MT $368
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.