How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,349 to $22,909Professionalmedian $8,913 · 10th to 90th $776 to $45,709
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 $602.56 Median $6,456.54 Typical High $14,454.40 | Facility | None | $602.56 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $8,912.51 Typical High $32,359.37 | Professional | None | $602.56 | $8,912.51 | $32,359.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $23,988.33 | Facility | None | $12,022.64 | $16,982.44 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $7,079.46 Typical High $50,118.72 | Professional | None | $1,023.29 | $7,079.46 | $50,118.72 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $20,892.96 Typical High $30,902.95 | Facility | None | $954.99 | $20,892.96 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $11,748.98 Typical High $25,118.86 | Professional | None | $776.25 | $11,748.98 | $25,118.86 |
DeanCare Setting Facility Modifier None Typical Low $575.44 Median $7,943.28 Typical High $14,454.40 | Facility | None | $575.44 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $20,892.96 | Professional | None | $1,071.52 | $1,584.89 | $20,892.96 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $9,120.11 Typical High $19,952.62 | Facility | None | $1,148.15 | $9,120.11 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $9,120.11 Median $25,703.96 Typical High $39,810.72 | Professional | None | $9,120.11 | $25,703.96 | $39,810.72 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $1,380.38 Median $9,772.37 Typical High $24,547.09 | Professional | None | $1,380.38 | $9,772.37 | $24,547.09 |
Prevea360 Setting Facility Modifier None Typical Low $501.19 Median $977.24 Typical High $13,803.84 | Facility | None | $501.19 | $977.24 | $13,803.84 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $7,413.10 Typical High $30,199.52 | Professional | None | $954.99 | $7,413.10 | $30,199.52 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $19,054.61 Typical High $31,622.78 | Facility | None | $758.58 | $19,054.61 | $31,622.78 |
Quartz Setting Professional Modifier None Typical Low $776.25 Median $1,584.89 Typical High $11,748.98 | Professional | None | $776.25 | $1,584.89 | $11,748.98 |
Security Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $39,810.72 | Professional | None | $2,344.23 | $2,344.23 | $39,810.72 |
Security Health Setting Professional Modifier None Typical Low $2,630.27 Median $31,622.78 Typical High $54,954.09 | Professional | None | $2,630.27 | $31,622.78 | $54,954.09 |
The Alliance Setting Professional Modifier None Typical Low $933.25 Median $2,344.23 Typical High $3,890.45 | Professional | None | $933.25 | $2,344.23 | $3,890.45 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $724.44 Median $6,606.93 Typical High $38,018.94 | Professional | None | $724.44 | $6,606.93 | $38,018.94 |
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 $302.00 Median $302.00 Typical High $4,466.84 | Facility | 52 · Reduced service | $302.00 | $302.00 | $4,466.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $1,819.70 | Facility | 53 · Discontinued | $120.23 | $120.23 | $1,819.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $6,760.83 | Facility | 54 · Surgery only | $457.09 | $457.09 | $6,760.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $1,348.96 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $1,348.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $891.25 | Facility | 56 · Pre-op care only | $60.26 | $60.26 | $891.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $4,466.84 Typical High $16,218.10 | Professional | 52 · Reduced service | $302.00 | $4,466.84 | $16,218.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $1,819.70 Typical High $6,456.54 | Professional | 53 · Discontinued | $120.23 | $1,819.70 | $6,456.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $6,760.83 Typical High $24,547.09 | Professional | 54 · Surgery only | $457.09 | $6,760.83 | $24,547.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $1,348.96 Typical High $4,897.79 | Professional | 55 · Aftercare only | $91.20 | $1,348.96 | $4,897.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $891.25 Typical High $3,235.94 | Professional | 56 · Pre-op care only | $60.26 | $891.25 | $3,235.94 |
Where Wisconsin sits
The same service costs 4.2 times more in Wisconsin than in Mississippi. 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
WI $23,367MS $5,576
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.