How much rates vary
Facilitymedian $1,905 · 10th to 90th $174 to $4,898Professionalmedian $209 · 10th to 90th $55 to $832
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 $44.67 Median $177.83 Typical High $14,454.40 | Facility | None | $44.67 | $177.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $177.83 Typical High $724.44 | Professional | None | $44.67 | $177.83 | $724.44 |
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 $58.88 Median $245.47 Typical High $1,000.00 | Professional | None | $58.88 | $245.47 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $436.52 Typical High $660.69 | Facility | None | $50.12 | $436.52 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $398.11 | Professional | None | $77.62 | $169.82 | $398.11 |
DeanCare Setting Facility Modifier None Typical Low $44.67 Median $7,244.36 Typical High $14,454.40 | Facility | None | $44.67 | $7,244.36 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $70.79 Median $169.82 Typical High $426.58 | Professional | None | $70.79 | $169.82 | $426.58 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $1,412.54 Typical High $3,019.95 | Facility | None | $173.78 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $602.56 Typical High $1,202.26 | Professional | None | $162.18 | $602.56 | $1,202.26 |
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 $89.13 Median $234.42 Typical High $398.11 | Professional | None | $89.13 | $234.42 | $398.11 |
Prevea360 Setting Facility Modifier None Typical Low $37.15 Median $79.43 Typical High $295.12 | Facility | None | $37.15 | $79.43 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $186.21 Typical High $616.60 | Professional | None | $63.10 | $186.21 | $616.60 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $302.00 | Professional | None | $77.62 | $158.49 | $302.00 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $616.60 | Professional | None | $144.54 | $144.54 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $467.74 Typical High $831.76 | Professional | None | $144.54 | $467.74 | $831.76 |
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 $47.86 Median $165.96 Typical High $645.65 | Professional | None | $47.86 | $165.96 | $645.65 |
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 $22.39 Median $22.39 Typical High $89.13 | Facility | 52 · Reduced service | $22.39 | $22.39 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $35.48 | Facility | 53 · Discontinued | $9.12 | $9.12 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $131.83 | Facility | 54 · Surgery only | $33.88 | $33.88 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $26.30 | Facility | 55 · Aftercare only | $6.76 | $6.76 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $17.78 | Facility | 56 · Pre-op care only | $4.47 | $4.47 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $89.13 Typical High $363.08 | Professional | 52 · Reduced service | $22.39 | $89.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $35.48 Typical High $144.54 | Professional | 53 · Discontinued | $9.12 | $35.48 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $131.83 Typical High $537.03 | Professional | 54 · Surgery only | $33.88 | $131.83 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $26.30 Typical High $107.15 | Professional | 55 · Aftercare only | $6.76 | $26.30 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $17.78 Typical High $72.44 | Professional | 56 · Pre-op care only | $4.47 | $17.78 | $72.44 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $35.48 Median $85.11 Typical High $213.80 | Professional | 51 · Multiple procedures | $35.48 | $85.11 | $213.80 |
Where Wisconsin sits
The same service costs 4.6 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
$240
WI $240DC $52.48
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.