How much rates vary
Facilitymedian $1,585 · 10th to 90th $195 to $4,266Professionalmedian $191 · 10th to 90th $65 to $692
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 $52.48 Median $144.54 Typical High $14,454.40 | Facility | None | $52.48 | $144.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $616.60 | Professional | None | $52.48 | $131.83 | $616.60 |
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 $69.18 Median $229.09 Typical High $812.83 | Professional | None | $69.18 | $229.09 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $724.44 | Facility | None | $199.53 | $346.74 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $323.59 | Professional | None | $89.13 | $177.83 | $323.59 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $2,570.40 Typical High $4,786.30 | Facility | None | $56.23 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $83.18 Median $177.83 Typical High $346.74 | Professional | None | $83.18 | $177.83 | $346.74 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $1,288.25 Typical High $3,019.95 | Facility | None | $213.80 | $1,288.25 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $489.78 Typical High $954.99 | Professional | None | $131.83 | $489.78 | $954.99 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $323.59 | Professional | None | $120.23 | $190.55 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $43.65 Median $100.00 Typical High $269.15 | Facility | None | $43.65 | $100.00 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $204.17 Typical High $537.03 | Professional | None | $74.13 | $204.17 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $1,071.52 | Facility | None | $194.98 | $295.12 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $245.47 | Professional | None | $89.13 | $158.49 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $478.63 | Professional | None | $173.78 | $173.78 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $645.65 | Professional | None | $190.55 | $281.84 | $645.65 |
The Alliance Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $741.31 | Professional | None | $208.93 | $316.23 | $741.31 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,548.13 | Facility | None | $512.86 | $2,238.72 | $3,548.13 |
United Setting Professional Modifier None Typical Low $58.88 Median $158.49 Typical High $512.86 | Professional | None | $58.88 | $158.49 | $512.86 |
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 $26.30 Median $26.30 Typical High $72.44 | Facility | 52 · Reduced service | $26.30 | $26.30 | $72.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $28.84 | Facility | 53 · Discontinued | $10.47 | $10.47 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $107.15 | Facility | 54 · Surgery only | $39.81 | $39.81 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $21.38 | Facility | 55 · Aftercare only | $7.94 | $7.94 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $14.45 | Facility | 56 · Pre-op care only | $5.25 | $5.25 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $72.44 Typical High $338.84 | Professional | 52 · Reduced service | $26.30 | $72.44 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $28.84 Typical High $134.90 | Professional | 53 · Discontinued | $10.47 | $28.84 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $107.15 Typical High $501.19 | Professional | 54 · Surgery only | $39.81 | $107.15 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $21.38 Typical High $100.00 | Professional | 55 · Aftercare only | $7.94 | $21.38 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $14.45 Typical High $67.61 | Professional | 56 · Pre-op care only | $5.25 | $14.45 | $67.61 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $89.13 Typical High $173.78 | Professional | 51 · Multiple procedures | $41.69 | $89.13 | $173.78 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska 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· 2nd of 51
$214
AK $224DC $63.10
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.