How much rates vary
Facilitymedian $2,884 · 10th to 90th $776 to $6,166Professionalmedian $1,000 · 10th to 90th $295 to $3,802
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 $245.47 Median $794.33 Typical High $14,454.40 | Facility | None | $245.47 | $794.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $794.33 Typical High $3,801.89 | Professional | None | $245.47 | $794.33 | $3,801.89 |
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 $323.59 Median $1,148.15 Typical High $4,466.84 | Professional | None | $323.59 | $1,148.15 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,187.76 Typical High $3,548.13 | Facility | None | $1,071.52 | $2,187.76 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $891.25 Typical High $1,819.70 | Professional | None | $416.87 | $891.25 | $1,819.70 |
DeanCare Setting Facility Modifier None Typical Low $257.04 Median $4,365.16 Typical High $7,762.47 | Facility | None | $257.04 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $912.01 Typical High $1,905.46 | Professional | None | $380.19 | $912.01 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $5,623.41 | Facility | None | $602.56 | $2,344.23 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,691.53 Typical High $5,370.32 | Professional | None | $912.01 | $2,691.53 | $5,370.32 |
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 $588.84 Median $1,071.52 Typical High $2,884.03 | Professional | None | $588.84 | $1,071.52 | $2,884.03 |
Prevea360 Setting Facility Modifier None Typical Low $239.88 Median $457.09 Typical High $1,318.26 | Facility | None | $239.88 | $457.09 | $1,318.26 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $977.24 Typical High $2,951.21 | Professional | None | $331.13 | $977.24 | $2,951.21 |
Quartz Setting Facility Modifier None Typical Low $954.99 Median $2,187.76 Typical High $3,715.35 | Facility | None | $954.99 | $2,187.76 | $3,715.35 |
Quartz Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $1,348.96 | Professional | None | $416.87 | $794.33 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $2,818.38 | Professional | None | $812.83 | $812.83 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $812.83 Median $1,995.26 Typical High $3,801.89 | Professional | None | $812.83 | $1,995.26 | $3,801.89 |
The Alliance Setting Professional Modifier None Typical Low $489.78 Median $1,096.48 Typical High $1,659.59 | Professional | None | $489.78 | $1,096.48 | $1,659.59 |
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 $288.40 Median $912.01 Typical High $2,951.21 | Professional | None | $288.40 | $912.01 | $2,951.21 |
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 $123.03 Median $123.03 Typical High $389.05 | Facility | 52 · Reduced service | $123.03 | $123.03 | $389.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $158.49 | Facility | 53 · Discontinued | $48.98 | $48.98 | $158.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $588.84 | Facility | 54 · Surgery only | $181.97 | $181.97 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $117.49 | Facility | 55 · Aftercare only | $36.31 | $36.31 | $117.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $79.43 | Facility | 56 · Pre-op care only | $24.55 | $24.55 | $79.43 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $389.05 Typical High $2,089.30 | Professional | 52 · Reduced service | $123.03 | $389.05 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $158.49 Typical High $851.14 | Professional | 53 · Discontinued | $48.98 | $158.49 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $588.84 Typical High $3,162.28 | Professional | 54 · Surgery only | $181.97 | $588.84 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $117.49 Typical High $630.96 | Professional | 55 · Aftercare only | $36.31 | $117.49 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $79.43 Typical High $416.87 | Professional | 56 · Pre-op care only | $24.55 | $79.43 | $416.87 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $457.09 Typical High $954.99 | Professional | 51 · Multiple procedures | $190.55 | $457.09 | $954.99 |
Where Wisconsin sits
The same service costs 3.4 times more in Colorado than in West Virginia. 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 $4,463WV $1,326
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.