How much rates vary
Facilitymedian $1,259 · 10th to 90th $229 to $3,802Professionalmedian $427 · 10th to 90th $110 to $1,905
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 $93.33 Median $354.81 Typical High $14,454.40 | Facility | None | $93.33 | $354.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $354.81 Typical High $3,467.37 | Professional | None | $93.33 | $354.81 | $3,467.37 |
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 $123.03 Median $501.19 Typical High $2,187.76 | Professional | None | $123.03 | $501.19 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $758.58 Typical High $1,479.11 | Facility | None | $229.09 | $758.58 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $831.76 | Professional | None | $158.49 | $354.81 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $100.00 Median $3,162.28 Typical High $5,888.44 | Facility | None | $100.00 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $354.81 Typical High $870.96 | Professional | None | $147.91 | $354.81 | $870.96 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $1,778.28 | Facility | None | $154.88 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,174.90 Typical High $2,454.71 | Professional | None | $407.38 | $1,174.90 | $2,454.71 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $223.87 Median $478.63 Typical High $1,348.96 | Professional | None | $223.87 | $478.63 | $1,348.96 |
Prevea360 Setting Facility Modifier None Typical Low $93.33 Median $169.82 Typical High $616.60 | Facility | None | $93.33 | $169.82 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $389.05 Typical High $1,174.90 | Professional | None | $117.49 | $389.05 | $1,174.90 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $1,479.11 | Facility | None | $223.87 | $346.74 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $616.60 | Professional | None | $158.49 | $331.13 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,318.26 | Professional | None | $302.00 | $302.00 | $1,318.26 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $1,174.90 Typical High $1,905.46 | Professional | None | $338.84 | $1,174.90 | $1,905.46 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $104.71 Median $363.08 Typical High $1,380.38 | Professional | None | $104.71 | $363.08 | $1,380.38 |
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 $46.77 Median $46.77 Typical High $177.83 | Facility | 52 · Reduced service | $46.77 | $46.77 | $177.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $72.44 | Facility | 53 · Discontinued | $18.62 | $18.62 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $269.15 | Facility | 54 · Surgery only | $70.79 | $70.79 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $53.70 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $35.48 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $35.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $177.83 Typical High $1,778.28 | Professional | 52 · Reduced service | $46.77 | $177.83 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $72.44 Typical High $707.95 | Professional | 53 · Discontinued | $18.62 | $72.44 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $269.15 Typical High $2,630.27 | Professional | 54 · Surgery only | $70.79 | $269.15 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $53.70 Typical High $524.81 | Professional | 55 · Aftercare only | $14.13 | $53.70 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $35.48 Typical High $354.81 | Professional | 56 · Pre-op care only | $9.33 | $35.48 | $354.81 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $177.83 Typical High $436.52 | Professional | 51 · Multiple procedures | $74.13 | $177.83 | $436.52 |
Where Wisconsin sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 1st of 51
$479
WI $479DC $100
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.