How much rates vary
Facilitymedian $5,248 · 10th to 90th $933 to $9,120Professionalmedian $741 · 10th to 90th $398 to $3,090
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 $398.11 Median $3,090.30 Typical High $14,454.40 | Facility | None | $398.11 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $4,677.35 | Professional | None | $380.19 | $398.11 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,230.27 Typical High $2,818.38 | Professional | None | $371.54 | $1,230.27 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $512.86 | Professional | None | $331.13 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,584.89 Typical High $5,011.87 | Facility | None | $891.25 | $1,584.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,513.56 | Professional | None | $549.54 | $676.08 | $1,513.56 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $3,162.28 Typical High $5,888.44 | Facility | None | $416.87 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,230.27 | Professional | None | $616.60 | $724.44 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $9,772.37 | Facility | None | $707.95 | $3,801.89 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,445.44 Typical High $3,715.35 | Professional | None | $478.63 | $1,445.44 | $3,715.35 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $501.19 Median $1,148.15 Typical High $1,380.38 | Professional | None | $501.19 | $1,148.15 | $1,380.38 |
Prevea360 Setting Facility Modifier None Typical Low $389.05 Median $602.56 Typical High $707.95 | Facility | None | $389.05 | $602.56 | $707.95 |
Quartz Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $1,548.82 | Professional | None | $354.81 | $724.44 | $1,548.82 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $3,311.31 Typical High $5,495.41 | Facility | None | $724.44 | $3,311.31 | $5,495.41 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $831.76 | Professional | None | $588.84 | $676.08 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,778.28 | $1,995.26 |
The Alliance Setting Professional Modifier None Typical Low $776.25 Median $1,659.59 Typical High $2,951.21 | Professional | None | $776.25 | $1,659.59 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $1,698.24 | Professional | None | $380.19 | $724.44 | $1,698.24 |
6 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 Professional Modifier 52 · Reduced service Typical Low $190.55 Median $194.98 Typical High $2,398.83 | Professional | 52 · Reduced service | $190.55 | $194.98 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $954.99 | Professional | 53 · Discontinued | $75.86 | $79.43 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $3,548.13 | Professional | 54 · Surgery only | $281.84 | $295.12 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $707.95 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $478.63 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $478.63 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $363.08 Typical High $602.56 | Professional | 51 · Multiple procedures | $309.03 | $363.08 | $602.56 |
Where Wisconsin sits
The same service costs 5.5 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 $6,136MT $1,125
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.