How much rates vary
Facilitymedian $2,138 · 10th to 90th $234 to $4,677Professionalmedian $309 · 10th to 90th $107 to $1,072
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 $89.13 Median $213.80 Typical High $14,454.40 | Facility | None | $89.13 | $213.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $213.80 Typical High $1,202.26 | Professional | None | $89.13 | $213.80 | $1,202.26 |
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 $117.49 Median $363.08 Typical High $1,148.15 | Professional | None | $117.49 | $363.08 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $512.86 Typical High $1,071.52 | Facility | None | $234.42 | $512.86 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $295.12 Typical High $524.81 | Professional | None | $151.36 | $295.12 | $524.81 |
DeanCare Setting Facility Modifier None Typical Low $93.33 Median $2,630.27 Typical High $5,128.61 | Facility | None | $93.33 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $512.86 | Professional | None | $138.04 | $269.15 | $512.86 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $2,041.74 Typical High $4,365.16 | Facility | None | $213.80 | $2,041.74 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $724.44 Typical High $1,412.54 | Professional | None | $229.09 | $724.44 | $1,412.54 |
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 $208.93 Median $316.23 Typical High $758.58 | Professional | None | $208.93 | $316.23 | $758.58 |
Prevea360 Setting Facility Modifier None Typical Low $87.10 Median $169.82 Typical High $363.08 | Facility | None | $87.10 | $169.82 | $363.08 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $331.13 Typical High $724.44 | Professional | None | $112.20 | $331.13 | $724.44 |
Quartz Setting Facility Modifier None Typical Low $229.09 Median $354.81 Typical High $1,479.11 | Facility | None | $229.09 | $354.81 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $363.08 | Professional | None | $151.36 | $239.88 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $724.44 | Professional | None | $295.12 | $295.12 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $954.99 | Professional | None | $295.12 | $562.34 | $954.99 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,677.35 | Facility | None | $707.95 | $2,754.23 | $4,677.35 |
United Setting Professional Modifier None Typical Low $102.33 Median $251.19 Typical High $794.33 | Professional | None | $102.33 | $251.19 | $794.33 |
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 $44.67 Median $44.67 Typical High $107.15 | Facility | 52 · Reduced service | $44.67 | $44.67 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $42.66 | Facility | 53 · Discontinued | $17.78 | $17.78 | $42.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $158.49 | Facility | 54 · Surgery only | $66.07 | $66.07 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $31.62 | Facility | 55 · Aftercare only | $13.18 | $13.18 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $21.38 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $107.15 Typical High $602.56 | Professional | 52 · Reduced service | $44.67 | $107.15 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $42.66 Typical High $239.88 | Professional | 53 · Discontinued | $17.78 | $42.66 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $158.49 Typical High $891.25 | Professional | 54 · Surgery only | $66.07 | $158.49 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $31.62 Typical High $177.83 | Professional | 55 · Aftercare only | $13.18 | $31.62 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $21.38 Typical High $120.23 | Professional | 56 · Pre-op care only | $8.91 | $21.38 | $120.23 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $69.18 Median $134.90 Typical High $257.04 | Professional | 51 · Multiple procedures | $69.18 | $134.90 | $257.04 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 2nd of 51
$347
AK $355MD $95.50
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.