How much rates vary
Facilitymedian $3,020 · 10th to 90th $490 to $8,710Professionalmedian $427 · 10th to 90th $229 to $1,778
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 $229.09 Median $229.09 Typical High $14,454.40 | Facility | None | $229.09 | $229.09 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $2,137.96 | Professional | None | $218.78 | $229.09 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,630.78 Typical High $6,918.31 | Facility | None | $1,995.26 | $3,630.78 | $6,918.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $691.83 Typical High $1,659.59 | Professional | None | $218.78 | $691.83 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $1,584.89 | Facility | None | $537.03 | $724.44 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $870.96 | Professional | None | $309.03 | $389.05 | $870.96 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $3,235.94 Typical High $5,888.44 | Facility | None | $229.09 | $3,235.94 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $707.95 | Professional | None | $363.08 | $426.58 | $707.95 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $2,454.71 Typical High $18,197.01 | Facility | None | $354.81 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $794.33 Typical High $1,778.28 | Professional | None | $257.04 | $794.33 | $1,778.28 |
Network Health Setting Facility Modifier None Typical Low $309.03 Median $446.68 Typical High $2,089.30 | Facility | None | $309.03 | $446.68 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $645.65 | Professional | None | $288.40 | $501.19 | $645.65 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $436.52 | Facility | None | $190.55 | $245.47 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $426.58 Typical High $891.25 | Professional | None | $208.93 | $426.58 | $891.25 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $489.78 | Professional | None | $331.13 | $389.05 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Security Health Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,174.90 | Professional | None | $691.83 | $912.01 | $1,174.90 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $977.24 | Professional | None | $213.80 | $371.54 | $977.24 |
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 $107.15 Median $114.82 Typical High $1,071.52 | Professional | 52 · Reduced service | $107.15 | $114.82 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $426.58 | Professional | 53 · Discontinued | $43.65 | $45.71 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $173.78 Typical High $1,621.81 | Professional | 54 · Surgery only | $162.18 | $173.78 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $34.67 Typical High $323.59 | Professional | 55 · Aftercare only | $33.11 | $34.67 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $213.80 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $213.80 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $213.80 Typical High $354.81 | Professional | 51 · Multiple procedures | $181.97 | $213.80 | $354.81 |
Where Wisconsin sits
The same service costs 13.4 times more in Maine 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
ME $8,787MT $655
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.