How much rates vary
Facilitymedian $1,380 · 10th to 90th $129 to $3,890Professionalmedian $170 · 10th to 90th $54 to $562
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 $45.71 Median $128.82 Typical High $14,454.40 | Facility | None | $45.71 | $128.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $120.23 Typical High $537.03 | Professional | None | $45.71 | $120.23 | $537.03 |
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 $194.98 Typical High $691.83 | Professional | None | $58.88 | $194.98 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $154.88 | Professional | None | $100.00 | $102.33 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $524.81 | Facility | None | $50.12 | $309.03 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $158.49 Typical High $354.81 | Professional | None | $77.62 | $158.49 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $45.71 Median $2,630.27 Typical High $5,128.61 | Facility | None | $45.71 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $288.40 | Professional | None | $72.44 | $158.49 | $288.40 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $912.01 Typical High $1,778.28 | Facility | None | $125.89 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $446.68 Typical High $870.96 | Professional | None | $109.65 | $446.68 | $870.96 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $251.19 | Professional | None | $89.13 | $169.82 | $251.19 |
Prevea360 Setting Facility Modifier None Typical Low $38.02 Median $81.28 Typical High $199.53 | Facility | None | $38.02 | $81.28 | $199.53 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $177.83 Typical High $416.87 | Professional | None | $67.61 | $177.83 | $416.87 |
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 $125.89 Typical High $218.78 | Professional | None | $77.62 | $125.89 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $457.09 | Professional | None | $147.91 | $147.91 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $602.56 | Professional | None | $144.54 | $239.88 | $602.56 |
The Alliance Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $524.81 | Professional | None | $154.88 | $239.88 | $524.81 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $47.86 Median $128.82 Typical High $426.58 | Professional | None | $47.86 | $128.82 | $426.58 |
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 $22.91 Median $22.91 Typical High $63.10 | Facility | 52 · Reduced service | $22.91 | $22.91 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $25.70 | Facility | 53 · Discontinued | $9.12 | $9.12 | $25.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $95.50 | Facility | 54 · Surgery only | $34.67 | $34.67 | $95.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $19.05 | Facility | 55 · Aftercare only | $6.92 | $6.92 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $12.88 | Facility | 56 · Pre-op care only | $4.57 | $4.57 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $63.10 Typical High $269.15 | Professional | 52 · Reduced service | $22.91 | $63.10 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $25.70 Typical High $107.15 | Professional | 53 · Discontinued | $9.12 | $25.70 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $95.50 Typical High $398.11 | Professional | 54 · Surgery only | $34.67 | $95.50 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $19.05 Typical High $79.43 | Professional | 55 · Aftercare only | $6.92 | $19.05 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $12.88 Typical High $53.70 | Professional | 56 · Pre-op care only | $4.57 | $12.88 | $53.70 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $79.43 Typical High $144.54 | Professional | 51 · Multiple procedures | $36.31 | $79.43 | $144.54 |
Where Wisconsin sits
The same service costs 3.4 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
$178
AK $178DC $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.