How much rates vary
Facilitymedian $2,818 · 10th to 90th $407 to $5,754Professionalmedian $316 · 10th to 90th $110 to $1,047
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 $89.13 Median $218.78 Typical High $14,454.40 | Facility | None | $89.13 | $218.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $1,380.38 | Professional | None | $89.13 | $218.78 | $1,380.38 |
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 $117.49 Median $389.05 Typical High $1,202.26 | Professional | None | $117.49 | $389.05 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $3,630.78 | Facility | None | $537.03 | $1,071.52 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $478.63 | Professional | None | $151.36 | $302.00 | $478.63 |
DeanCare Setting Facility Modifier None Typical Low $95.50 Median $2,570.40 Typical High $4,786.30 | Facility | None | $95.50 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $524.81 | Professional | None | $141.25 | $288.40 | $524.81 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $2,187.76 Typical High $6,309.57 | Facility | None | $338.84 | $2,187.76 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $794.33 Typical High $1,479.11 | Professional | None | $204.17 | $794.33 | $1,479.11 |
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 $190.55 Median $316.23 Typical High $501.19 | Professional | None | $190.55 | $316.23 | $501.19 |
Prevea360 Setting Facility Modifier None Typical Low $74.13 Median $173.78 Typical High $407.38 | Facility | None | $74.13 | $173.78 | $407.38 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $346.74 Typical High $741.31 | Professional | None | $131.83 | $346.74 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $3,981.07 | Facility | None | $630.96 | $2,398.83 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $371.54 | Professional | None | $151.36 | $234.42 | $371.54 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $776.25 | Professional | None | $295.12 | $295.12 | $776.25 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,023.29 | Professional | None | $295.12 | $478.63 | $1,023.29 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $741.31 | Professional | None | $100.00 | $251.19 | $741.31 |
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 $44.67 Median $44.67 Typical High $109.65 | Facility | 52 · Reduced service | $44.67 | $44.67 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $43.65 | Facility | 53 · Discontinued | $17.78 | $17.78 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $165.96 | Facility | 54 · Surgery only | $67.61 | $67.61 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $33.11 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $21.88 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $109.65 Typical High $691.83 | Professional | 52 · Reduced service | $44.67 | $109.65 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $43.65 Typical High $275.42 | Professional | 53 · Discontinued | $17.78 | $43.65 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $165.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $67.61 | $165.96 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $33.11 Typical High $204.17 | Professional | 55 · Aftercare only | $13.49 | $33.11 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $21.88 Typical High $138.04 | Professional | 56 · Pre-op care only | $8.91 | $21.88 | $138.04 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $70.79 Median $144.54 Typical High $263.03 | Professional | 51 · Multiple procedures | $70.79 | $144.54 | $263.03 |
Where Wisconsin sits
The same service costs 4.5 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
$347
AK $437DC $97.72
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.