How much rates vary
Facilitymedian $6,310 · 10th to 90th $457 to $11,482Professionalmedian $513 · 10th to 90th $112 to $2,399
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 $77.62 Median $457.09 Typical High $14,454.40 | Facility | None | $77.62 | $457.09 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $457.09 Typical High $2,511.89 | Professional | None | $77.62 | $457.09 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $6,760.83 Typical High $11,481.54 | Facility | None | $1,202.26 | $6,760.83 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $562.34 Typical High $2,570.40 | Professional | None | $134.90 | $562.34 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,862.09 | Facility | None | $1,122.02 | $1,258.93 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $446.68 Typical High $1,737.80 | Professional | None | $131.83 | $446.68 | $1,737.80 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $3,162.28 Typical High $5,888.44 | Facility | None | $117.49 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $125.89 Median $323.59 Typical High $1,122.02 | Professional | None | $125.89 | $323.59 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $7,585.78 Typical High $11,481.54 | Facility | None | $144.54 | $7,585.78 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,548.82 Typical High $3,090.30 | Professional | None | $489.78 | $1,548.82 | $3,090.30 |
Network Health Setting Facility Modifier None Typical Low $7,762.47 Median $8,317.64 Typical High $9,120.11 | Facility | None | $7,762.47 | $8,317.64 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $204.17 Median $602.56 Typical High $1,698.24 | Professional | None | $204.17 | $602.56 | $1,698.24 |
Prevea360 Setting Facility Modifier None Typical Low $75.86 Median $144.54 Typical High $724.44 | Facility | None | $75.86 | $144.54 | $724.44 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $446.68 Typical High $1,479.11 | Professional | None | $107.15 | $446.68 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $275.42 Typical High $912.01 | Professional | None | $131.83 | $275.42 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $1,659.59 | Professional | None | $257.04 | $257.04 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $309.03 Median $1,096.48 Typical High $2,398.83 | Professional | None | $309.03 | $1,096.48 | $2,398.83 |
The Alliance Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $416.87 | Professional | None | $199.53 | $295.12 | $416.87 |
United Setting Facility Modifier None Typical Low $6,309.57 Median $10,232.93 Typical High $12,022.64 | Facility | None | $6,309.57 | $10,232.93 | $12,022.64 |
United Setting Professional Modifier None Typical Low $112.20 Median $436.52 Typical High $1,778.28 | Professional | None | $112.20 | $436.52 | $1,778.28 |
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 $38.90 Median $38.90 Typical High $229.09 | Facility | 52 · Reduced service | $38.90 | $38.90 | $229.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $91.20 | Facility | 53 · Discontinued | $15.49 | $15.49 | $91.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $338.84 | Facility | 54 · Surgery only | $57.54 | $57.54 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $67.61 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $45.71 | Facility | 56 · Pre-op care only | $7.76 | $7.76 | $45.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $229.09 Typical High $1,288.25 | Professional | 52 · Reduced service | $38.90 | $229.09 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $91.20 Typical High $524.81 | Professional | 53 · Discontinued | $15.49 | $91.20 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $338.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $57.54 | $338.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $67.61 Typical High $389.05 | Professional | 55 · Aftercare only | $11.48 | $67.61 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $45.71 Typical High $257.04 | Professional | 56 · Pre-op care only | $7.76 | $45.71 | $257.04 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $162.18 Typical High $562.34 | Professional | 51 · Multiple procedures | $63.10 | $162.18 | $562.34 |
Where Wisconsin sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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
$617
WI $617MD $110
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.