How much rates vary
Facilitymedian $1,202 · 10th to 90th $112 to $3,802Professionalmedian $158 · 10th to 90th $43 to $589
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 $33.88 Median $112.20 Typical High $14,454.40 | Facility | None | $33.88 | $112.20 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $112.20 Typical High $891.25 | Professional | None | $33.88 | $112.20 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $208.93 Typical High $707.95 | Professional | None | $66.07 | $208.93 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $223.87 Typical High $363.08 | Facility | None | $50.12 | $223.87 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $125.89 Typical High $426.58 | Professional | None | $41.69 | $125.89 | $426.58 |
DeanCare Setting Facility Modifier None Typical Low $35.48 Median $2,570.40 Typical High $4,786.30 | Facility | None | $35.48 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $338.84 | Professional | None | $64.57 | $112.20 | $338.84 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $912.01 Typical High $1,778.28 | Facility | None | $112.20 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $346.74 Typical High $741.31 | Professional | None | $100.00 | $346.74 | $741.31 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $398.11 | Professional | None | $87.10 | $147.91 | $398.11 |
Prevea360 Setting Facility Modifier None Typical Low $32.36 Median $91.20 Typical High $213.80 | Facility | None | $32.36 | $91.20 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $154.88 Typical High $436.52 | Professional | None | $63.10 | $154.88 | $436.52 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $165.96 Typical High $269.15 | Facility | None | $50.12 | $165.96 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $41.69 Median $114.82 Typical High $177.83 | Professional | None | $41.69 | $114.82 | $177.83 |
Security Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $371.54 | Professional | None | $102.33 | $102.33 | $371.54 |
Security Health Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $575.44 | Professional | None | $120.23 | $199.53 | $575.44 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $41.69 Median $138.04 Typical High $467.74 | Professional | None | $41.69 | $138.04 | $467.74 |
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 $16.98 Median $16.98 Typical High $56.23 | Facility | 52 · Reduced service | $16.98 | $16.98 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $22.39 | Facility | 53 · Discontinued | $6.76 | $6.76 | $22.39 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $85.11 | Facility | 54 · Surgery only | $25.12 | $25.12 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $16.98 | Facility | 55 · Aftercare only | $5.01 | $5.01 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $11.22 | Facility | 56 · Pre-op care only | $3.39 | $3.39 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $56.23 Typical High $446.68 | Professional | 52 · Reduced service | $16.98 | $56.23 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $22.39 Typical High $177.83 | Professional | 53 · Discontinued | $6.76 | $22.39 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $85.11 Typical High $676.08 | Professional | 54 · Surgery only | $25.12 | $85.11 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $16.98 Typical High $134.90 | Professional | 55 · Aftercare only | $5.01 | $16.98 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $11.22 Typical High $89.13 | Professional | 56 · Pre-op care only | $3.39 | $11.22 | $89.13 |
Where Wisconsin sits
The same service costs 5.4 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
$209
WI $209HI $38.90
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.