How much rates vary
Facilitymedian $2,754 · 10th to 90th $661 to $5,754Professionalmedian $437 · 10th to 90th $251 to $1,698
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 $251.19 Median $1,905.46 Typical High $14,454.40 | Facility | None | $251.19 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $2,570.40 | Professional | None | $245.47 | $251.19 | $2,570.40 |
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 $229.09 Median $691.83 Typical High $1,819.70 | Professional | None | $229.09 | $691.83 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,071.52 Typical High $1,819.70 | Facility | None | $588.84 | $1,071.52 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $954.99 | Professional | None | $371.54 | $426.58 | $954.99 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $2,818.38 Typical High $5,370.32 | Facility | None | $251.19 | $2,818.38 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $776.25 | Professional | None | $389.05 | $457.09 | $776.25 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,398.83 Typical High $4,365.16 | Facility | None | $588.84 | $2,398.83 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $776.25 Typical High $1,698.24 | Professional | None | $288.40 | $776.25 | $1,698.24 |
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 $245.47 Median $562.34 Typical High $870.96 | Professional | None | $245.47 | $562.34 | $870.96 |
Prevea360 Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $467.74 | Facility | None | $204.17 | $251.19 | $467.74 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $457.09 Typical High $977.24 | Professional | None | $223.87 | $457.09 | $977.24 |
Quartz Setting Facility Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,995.26 | Facility | None | $831.76 | $1,202.26 | $1,995.26 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | None | $426.58 | $426.58 | $524.81 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,258.93 | Professional | None | $831.76 | $1,122.02 | $1,258.93 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $239.88 Median $407.38 Typical High $1,047.13 | Professional | None | $239.88 | $407.38 | $1,047.13 |
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 $120.23 Median $125.89 Typical High $1,288.25 | Professional | 52 · Reduced service | $120.23 | $125.89 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $512.86 | Professional | 53 · Discontinued | $50.12 | $50.12 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $1,949.84 | Professional | 54 · Surgery only | $181.97 | $186.21 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $389.05 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $257.04 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $257.04 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $229.09 Typical High $389.05 | Professional | 51 · Multiple procedures | $194.98 | $229.09 | $389.05 |
Where Wisconsin sits
The same service costs 4.7 times more in Wyoming than in Utah. 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· 5th of 51
$525
WY $912UT $195
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.