How much rates vary
Facilitymedian $2,630 · 10th to 90th $741 to $5,623Professionalmedian $1,000 · 10th to 90th $234 to $3,890
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 $213.80 Median $912.01 Typical High $14,454.40 | Facility | None | $213.80 | $912.01 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $812.83 Typical High $3,311.31 | Professional | None | $213.80 | $812.83 | $3,311.31 |
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 $309.03 Median $1,122.02 Typical High $4,466.84 | Professional | None | $309.03 | $1,122.02 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $2,137.96 | Facility | None | $812.83 | $1,412.54 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $676.08 Typical High $2,344.23 | Professional | None | $302.00 | $676.08 | $2,344.23 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $2,630.27 Typical High $5,128.61 | Facility | None | $204.17 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $1,862.09 | Professional | None | $295.12 | $562.34 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $4,365.16 | Facility | None | $588.84 | $2,187.76 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $2,630.27 Typical High $5,128.61 | Professional | None | $812.83 | $2,630.27 | $5,128.61 |
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 $407.38 Median $1,023.29 Typical High $2,570.40 | Professional | None | $407.38 | $1,023.29 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $1,230.27 | Facility | None | $177.83 | $346.74 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $758.58 Typical High $2,630.27 | Professional | None | $263.03 | $758.58 | $2,630.27 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,584.89 | Facility | None | $758.58 | $1,096.48 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $575.44 Typical High $1,445.44 | Professional | None | $302.00 | $575.44 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $3,801.89 | Professional | None | $851.14 | $851.14 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $2,398.83 Typical High $5,128.61 | Professional | None | $851.14 | $2,398.83 | $5,128.61 |
The Alliance Setting Professional Modifier None Typical Low $275.42 Median $691.83 Typical High $977.24 | Professional | None | $275.42 | $691.83 | $977.24 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $234.42 Median $831.76 Typical High $3,019.95 | Professional | None | $234.42 | $831.76 | $3,019.95 |
11 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 $107.15 Median $107.15 Typical High $457.09 | Facility | 52 · Reduced service | $107.15 | $107.15 | $457.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $181.97 | Facility | 53 · Discontinued | $42.66 | $42.66 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $676.08 | Facility | 54 · Surgery only | $162.18 | $162.18 | $676.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $134.90 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $91.20 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $457.09 Typical High $1,949.84 | Professional | 52 · Reduced service | $107.15 | $457.09 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $181.97 Typical High $776.25 | Professional | 53 · Discontinued | $42.66 | $181.97 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $676.08 Typical High $2,884.03 | Professional | 54 · Surgery only | $162.18 | $676.08 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $134.90 Typical High $575.44 | Professional | 55 · Aftercare only | $32.36 | $134.90 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $91.20 Typical High $389.05 | Professional | 56 · Pre-op care only | $21.38 | $91.20 | $389.05 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $281.84 Typical High $933.25 | Professional | 51 · Multiple procedures | $147.91 | $281.84 | $933.25 |
Where Wisconsin sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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
$1,148
WI $1,148HI $219
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.