How much rates vary
Facilitymedian $7,943 · 10th to 90th $759 to $15,136Professionalmedian $468 · 10th to 90th $170 to $1,023
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 $169.82 Median $6,456.54 Typical High $14,454.40 | Facility | None | $169.82 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $1,380.38 | Professional | None | $169.82 | $169.82 | $1,380.38 |
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 $147.91 Median $524.81 Typical High $1,023.29 | Professional | None | $147.91 | $524.81 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,202.26 Typical High $7,943.28 | Facility | None | $331.13 | $1,202.26 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $707.95 | Professional | None | $239.88 | $407.38 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $165.96 Median $4,365.16 Typical High $7,762.47 | Facility | None | $165.96 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $457.09 | Professional | None | $275.42 | $338.84 | $457.09 |
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 $173.78 Median $467.74 Typical High $758.58 | Professional | None | $173.78 | $467.74 | $758.58 |
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 $186.21 Median $346.74 Typical High $478.63 | Professional | None | $186.21 | $346.74 | $478.63 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $204.17 Typical High $933.25 | Facility | None | $141.25 | $204.17 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $138.04 Median $316.23 Typical High $588.84 | Professional | None | $138.04 | $316.23 | $588.84 |
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 $239.88 Median $239.88 Typical High $309.03 | Professional | None | $239.88 | $239.88 | $309.03 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $954.99 | Professional | None | $630.96 | $891.25 | $954.99 |
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 $154.88 Median $478.63 Typical High $724.44 | Professional | None | $154.88 | $478.63 | $724.44 |
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 $85.11 Median $85.11 Typical High $691.83 | Professional | 52 · Reduced service | $85.11 | $85.11 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $275.42 | Professional | 53 · Discontinued | $34.67 | $34.67 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $1,047.13 | Professional | 54 · Surgery only | $128.82 | $128.82 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $208.93 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $138.04 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $138.04 |
Where Wisconsin sits
The same service costs 20.4 times more in Kansas 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
$724
KS $3,020NY $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.