How much rates vary
Facilitymedian $2,630 · 10th to 90th $661 to $5,623Professionalmedian $1,000 · 10th to 90th $112 to $5,370
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 $1,000.00 Typical High $14,454.40 | Facility | None | $93.33 | $1,000.00 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $1,000.00 Typical High $6,606.93 | Professional | None | $93.33 | $1,000.00 | $6,606.93 |
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 $123.03 Median $912.01 Typical High $6,025.60 | Professional | None | $123.03 | $912.01 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,659.59 Typical High $2,884.03 | Facility | None | $758.58 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $416.87 Typical High $2,398.83 | Professional | None | $154.88 | $416.87 | $2,398.83 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $2,630.27 Typical High $5,128.61 | Facility | None | $97.72 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $2,454.71 | Professional | None | $147.91 | $346.74 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,187.76 Typical High $4,365.16 | Facility | None | $501.19 | $2,187.76 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $3,467.37 Typical High $6,918.31 | Professional | None | $1,047.13 | $3,467.37 | $6,918.31 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $204.17 Median $1,412.54 Typical High $2,454.71 | Professional | None | $204.17 | $1,412.54 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $234.42 Typical High $1,737.80 | Facility | None | $91.20 | $234.42 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $977.24 Typical High $3,715.35 | Professional | None | $131.83 | $977.24 | $3,715.35 |
Quartz Setting Facility Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,905.46 | Facility | None | $676.08 | $1,202.26 | $1,905.46 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $1,698.24 | Professional | None | $158.49 | $331.13 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $3,715.35 | Professional | None | $302.00 | $302.00 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $5,011.87 | Professional | None | $302.00 | $501.19 | $5,011.87 |
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 $100.00 Median $741.31 Typical High $3,981.07 | Professional | None | $100.00 | $741.31 | $3,981.07 |
10 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 $501.19 | Facility | 52 · Reduced service | $46.77 | $46.77 | $501.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $199.53 | Facility | 53 · Discontinued | $18.62 | $18.62 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $758.58 | Facility | 54 · Surgery only | $69.18 | $69.18 | $758.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $151.36 | Facility | 55 · Aftercare only | $13.80 | $13.80 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $501.19 Typical High $3,235.94 | Professional | 52 · Reduced service | $46.77 | $501.19 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $199.53 Typical High $1,318.26 | Professional | 53 · Discontinued | $18.62 | $199.53 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $758.58 Typical High $4,897.79 | Professional | 54 · Surgery only | $69.18 | $758.58 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $151.36 Typical High $977.24 | Professional | 55 · Aftercare only | $13.80 | $151.36 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $100.00 Typical High $660.69 | Professional | 56 · Pre-op care only | $9.33 | $100.00 | $660.69 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $173.78 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $72.44 | $173.78 | $1,230.27 |
Where Wisconsin sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 3rd of 51
$1,122
WA $1,288KY $91.20
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.