How much rates vary
Facilitymedian $1,202 · 10th to 90th $79 to $3,802Professionalmedian $145 · 10th to 90th $45 to $479
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 $30.90 Median $79.43 Typical High $14,454.40 | Facility | None | $30.90 | $79.43 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $79.43 Typical High $537.03 | Professional | None | $30.90 | $79.43 | $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 $57.54 Median $186.21 Typical High $501.19 | Professional | None | $57.54 | $186.21 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $239.88 | Facility | None | $50.12 | $141.25 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $104.71 Typical High $281.84 | Professional | None | $39.81 | $104.71 | $281.84 |
DeanCare Setting Facility Modifier None Typical Low $34.67 Median $2,630.27 Typical High $5,128.61 | Facility | None | $34.67 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $239.88 | Professional | None | $63.10 | $100.00 | $239.88 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $912.01 Typical High $1,778.28 | Facility | None | $83.18 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $239.88 Typical High $489.78 | Professional | None | $87.10 | $239.88 | $489.78 |
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 $97.72 Median $141.25 Typical High $257.04 | Professional | None | $97.72 | $141.25 | $257.04 |
Prevea360 Setting Facility Modifier None Typical Low $30.20 Median $61.66 Typical High $141.25 | Facility | None | $30.20 | $61.66 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $309.03 | Professional | None | $57.54 | $125.89 | $309.03 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $154.88 | Facility | None | $50.12 | $102.33 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $39.81 Median $100.00 Typical High $141.25 | Professional | None | $39.81 | $100.00 | $141.25 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $398.11 | Professional | None | $154.88 | $154.88 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $588.84 | Professional | None | $173.78 | $251.19 | $588.84 |
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 $46.77 Median $120.23 Typical High $316.23 | Professional | None | $46.77 | $120.23 | $316.23 |
10 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 $15.49 Median $15.49 Typical High $39.81 | Facility | 52 · Reduced service | $15.49 | $15.49 | $39.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $15.85 | Facility | 53 · Discontinued | $6.17 | $6.17 | $15.85 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $60.26 | Facility | 54 · Surgery only | $22.91 | $22.91 | $60.26 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $12.02 | Facility | 55 · Aftercare only | $4.57 | $4.57 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $7.94 | Facility | 56 · Pre-op care only | $3.09 | $3.09 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $39.81 Typical High $302.00 | Professional | 52 · Reduced service | $15.49 | $39.81 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $15.85 Typical High $120.23 | Professional | 53 · Discontinued | $6.17 | $15.85 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $60.26 Typical High $446.68 | Professional | 54 · Surgery only | $22.91 | $60.26 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $12.02 Typical High $91.20 | Professional | 55 · Aftercare only | $4.57 | $12.02 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $7.94 Typical High $60.26 | Professional | 56 · Pre-op care only | $3.09 | $7.94 | $60.26 |
Where Wisconsin sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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
$186
WI $186NE $60.26
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.