How much rates vary
Facilitymedian $2,754 · 10th to 90th $661 to $5,754Professionalmedian $891 · 10th to 90th $269 to $3,467
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 $218.78 Median $676.08 Typical High $14,454.40 | Facility | None | $218.78 | $676.08 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $660.69 Typical High $2,041.74 | Professional | None | $218.78 | $660.69 | $2,041.74 |
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 $288.40 Median $977.24 Typical High $4,168.69 | Professional | None | $288.40 | $977.24 | $4,168.69 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $812.83 | Professional | None | $524.81 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $2,570.40 | Facility | None | $1,000.00 | $1,778.28 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $776.25 Typical High $1,584.89 | Professional | None | $371.54 | $776.25 | $1,584.89 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $3,090.30 Typical High $5,370.32 | Facility | None | $229.09 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $346.74 Median $851.14 Typical High $1,621.81 | Professional | None | $346.74 | $851.14 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $4,897.79 | Facility | None | $588.84 | $2,187.76 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $2,344.23 Typical High $4,570.88 | Professional | None | $407.38 | $2,344.23 | $4,570.88 |
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 $645.65 Median $1,584.89 Typical High $1,698.24 | Professional | None | $645.65 | $1,584.89 | $1,698.24 |
Prevea360 Setting Facility Modifier None Typical Low $213.80 Median $562.34 Typical High $1,258.93 | Facility | None | $213.80 | $562.34 | $1,258.93 |
Quartz Setting Professional Modifier None Typical Low $295.12 Median $851.14 Typical High $2,511.89 | Professional | None | $295.12 | $851.14 | $2,511.89 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $1,621.81 Typical High $2,570.40 | Facility | None | $724.44 | $1,621.81 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $630.96 Typical High $1,148.15 | Professional | None | $371.54 | $630.96 | $1,148.15 |
Security Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,454.71 | Professional | None | $724.44 | $724.44 | $2,454.71 |
Security Health Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $3,311.31 | Professional | None | $724.44 | $1,096.48 | $3,311.31 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $257.04 Median $741.31 Typical High $2,691.53 | Professional | None | $257.04 | $741.31 | $2,691.53 |
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 $109.65 Median $109.65 Typical High $338.84 | Facility | 52 · Reduced service | $109.65 | $109.65 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $134.90 | Facility | 53 · Discontinued | $43.65 | $43.65 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $501.19 | Facility | 54 · Surgery only | $162.18 | $162.18 | $501.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $102.33 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $67.61 | Facility | 56 · Pre-op care only | $21.88 | $21.88 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $338.84 Typical High $1,445.44 | Professional | 52 · Reduced service | $109.65 | $338.84 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $134.90 Typical High $575.44 | Professional | 53 · Discontinued | $43.65 | $134.90 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $501.19 Typical High $2,187.76 | Professional | 54 · Surgery only | $162.18 | $501.19 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $102.33 Typical High $436.52 | Professional | 55 · Aftercare only | $32.36 | $102.33 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $67.61 Typical High $288.40 | Professional | 56 · Pre-op care only | $21.88 | $67.61 | $288.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $426.58 Typical High $812.83 | Professional | 51 · Multiple procedures | $169.82 | $426.58 | $812.83 |
Where Wisconsin sits
The same service costs 4.1 times more in Colorado than in Montana. 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
CO $4,259MT $1,038
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.