How much rates vary
Facilitymedian $3,311 · 10th to 90th $355 to $7,943Professionalmedian $316 · 10th to 90th $120 to $933
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 $100.00 Median $190.55 Typical High $14,454.40 | Facility | None | $100.00 | $190.55 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $1,096.48 | Professional | None | $100.00 | $190.55 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $389.05 Typical High $1,071.52 | Professional | None | $131.83 | $389.05 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,047.13 Typical High $3,630.78 | Facility | None | $467.74 | $1,047.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $549.54 | Professional | None | $169.82 | $302.00 | $549.54 |
DeanCare Setting Facility Modifier None Typical Low $134.90 Median $2,570.40 Typical High $4,786.30 | Facility | None | $134.90 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $467.74 | Professional | None | $154.88 | $302.00 | $467.74 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $2,818.38 Typical High $8,317.64 | Facility | None | $295.12 | $2,818.38 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $870.96 Typical High $1,318.26 | Professional | None | $190.55 | $870.96 | $1,318.26 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $416.87 | Professional | None | $208.93 | $323.59 | $416.87 |
Prevea360 Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $354.81 | Facility | None | $97.72 | $181.97 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $660.69 | Professional | None | $141.25 | $338.84 | $660.69 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $3,981.07 | Facility | None | $724.44 | $2,398.83 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $354.81 | Professional | None | $169.82 | $213.80 | $354.81 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $691.83 | Professional | None | $331.13 | $331.13 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $891.25 | Professional | None | $331.13 | $501.19 | $891.25 |
The Alliance Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $676.08 | Professional | None | $549.54 | $549.54 | $676.08 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $660.69 | Professional | None | $114.82 | $213.80 | $660.69 |
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 $50.12 Median $50.12 Typical High $95.50 | Facility | 52 · Reduced service | $50.12 | $50.12 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $38.90 | Facility | 53 · Discontinued | $19.95 | $19.95 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $144.54 | Facility | 54 · Surgery only | $74.13 | $74.13 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $28.84 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $19.05 | Facility | 56 · Pre-op care only | $10.00 | $10.00 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $95.50 Typical High $549.54 | Professional | 52 · Reduced service | $50.12 | $95.50 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $38.90 Typical High $218.78 | Professional | 53 · Discontinued | $19.95 | $38.90 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $144.54 Typical High $812.83 | Professional | 54 · Surgery only | $74.13 | $144.54 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $28.84 Typical High $162.18 | Professional | 55 · Aftercare only | $14.79 | $28.84 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.05 Typical High $109.65 | Professional | 56 · Pre-op care only | $10.00 | $19.05 | $109.65 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $151.36 Typical High $234.42 | Professional | 51 · Multiple procedures | $77.62 | $151.36 | $234.42 |
Where Wisconsin sits
The same service costs 3.6 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· 3rd of 51
$331
AK $407DC $112
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.