How much rates vary
Facilitymedian $2,344 · 10th to 90th $87 to $5,623Professionalmedian $135 · 10th to 90th $72 to $479
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 $66.07 Median $83.18 Typical High $14,454.40 | Facility | None | $66.07 | $83.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $537.03 | Professional | None | $66.07 | $83.18 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $223.87 Typical High $512.86 | Professional | None | $77.62 | $223.87 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $199.53 Typical High $812.83 | Facility | None | $81.28 | $199.53 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $257.04 | Professional | None | $81.28 | $102.33 | $257.04 |
DeanCare Setting Facility Modifier None Typical Low $66.07 Median $2,630.27 Typical High $5,128.61 | Facility | None | $66.07 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | None | $104.71 | $134.90 | $204.17 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $2,041.74 Typical High $4,365.16 | Facility | None | $97.72 | $2,041.74 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $436.52 Typical High $549.54 | Professional | None | $97.72 | $436.52 | $549.54 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $229.09 | Professional | None | $128.82 | $186.21 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $81.28 Typical High $151.36 | Facility | None | $54.95 | $81.28 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $281.84 | Professional | None | $85.11 | $162.18 | $281.84 |
Quartz Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $1,096.48 | Facility | None | $79.43 | $120.23 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $128.82 | Professional | None | $81.28 | $102.33 | $128.82 |
Security Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | None | $208.93 | $208.93 | $275.42 |
Security Health Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $380.19 | Professional | None | $208.93 | $295.12 | $380.19 |
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 $69.18 Median $114.82 Typical High $331.13 | Professional | None | $69.18 | $114.82 | $331.13 |
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 $33.11 Median $33.11 Typical High $41.69 | Facility | 52 · Reduced service | $33.11 | $33.11 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $16.60 | Facility | 53 · Discontinued | $13.18 | $13.18 | $16.60 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $61.66 | Facility | 54 · Surgery only | $50.12 | $50.12 | $61.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $12.30 | Facility | 55 · Aftercare only | $10.00 | $10.00 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $8.32 | Facility | 56 · Pre-op care only | $6.61 | $6.61 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $41.69 Typical High $269.15 | Professional | 52 · Reduced service | $33.11 | $41.69 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $16.60 Typical High $107.15 | Professional | 53 · Discontinued | $13.18 | $16.60 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $61.66 Typical High $398.11 | Professional | 54 · Surgery only | $50.12 | $61.66 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.30 Typical High $79.43 | Professional | 55 · Aftercare only | $10.00 | $12.30 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.32 Typical High $53.70 | Professional | 56 · Pre-op care only | $6.61 | $8.32 | $53.70 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $52.48 Median $66.07 Typical High $102.33 | Professional | 51 · Multiple procedures | $52.48 | $66.07 | $102.33 |
Where Wisconsin sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 3rd of 51
$155
AK $240NJ $56.23
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.