How much rates vary
Facilitymedian $6,761 · 10th to 90th $912 to $11,482Professionalmedian $1,259 · 10th to 90th $331 to $4,786
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 $229.09 Median $912.01 Typical High $14,454.40 | Facility | None | $229.09 | $912.01 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $912.01 Typical High $3,162.28 | Professional | None | $229.09 | $912.01 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,412.54 Typical High $5,623.41 | Professional | None | $398.11 | $1,412.54 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,715.35 | Facility | None | $2,187.76 | $2,511.89 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $891.25 Typical High $3,311.31 | Professional | None | $389.05 | $891.25 | $3,311.31 |
DeanCare Setting Facility Modifier None Typical Low $354.81 Median $3,162.28 Typical High $5,888.44 | Facility | None | $354.81 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $2,238.72 | Professional | None | $380.19 | $724.44 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $7,585.78 Typical High $11,481.54 | Facility | None | $436.52 | $7,585.78 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $3,090.30 Typical High $6,165.95 | Professional | None | $1,096.48 | $3,090.30 | $6,165.95 |
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 $602.56 Median $1,230.27 Typical High $3,388.44 | Professional | None | $602.56 | $1,230.27 | $3,388.44 |
Prevea360 Setting Facility Modifier None Typical Low $223.87 Median $436.52 Typical High $1,548.82 | Facility | None | $223.87 | $436.52 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $1,000.00 Typical High $3,630.78 | Professional | None | $316.23 | $1,000.00 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $389.05 Median $812.83 Typical High $1,819.70 | Professional | None | $389.05 | $812.83 | $1,819.70 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $3,235.94 | Professional | None | $758.58 | $758.58 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $2,570.40 Typical High $4,897.79 | Professional | None | $933.25 | $2,570.40 | $4,897.79 |
The Alliance Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,258.93 | $1,548.82 |
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 $316.23 Median $1,071.52 Typical High $3,890.45 | Professional | None | $316.23 | $1,071.52 | $3,890.45 |
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 $114.82 Median $114.82 Typical High $457.09 | Facility | 52 · Reduced service | $114.82 | $114.82 | $457.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $181.97 | Facility | 53 · Discontinued | $45.71 | $45.71 | $181.97 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $676.08 | Facility | 54 · Surgery only | $169.82 | $169.82 | $676.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $134.90 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $134.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $91.20 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $457.09 Typical High $1,584.89 | Professional | 52 · Reduced service | $114.82 | $457.09 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $181.97 Typical High $630.96 | Professional | 53 · Discontinued | $45.71 | $181.97 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $676.08 Typical High $2,344.23 | Professional | 54 · Surgery only | $169.82 | $676.08 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $134.90 Typical High $467.74 | Professional | 55 · Aftercare only | $33.88 | $134.90 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $91.20 Typical High $316.23 | Professional | 56 · Pre-op care only | $22.91 | $91.20 | $316.23 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $363.08 Typical High $1,122.02 | Professional | 51 · Multiple procedures | $190.55 | $363.08 | $1,122.02 |
Where Wisconsin sits
The same service costs 5.4 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
$1,514
WI $1,514MD $282
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.