How much rates vary
Facilitymedian $1,349 · 10th to 90th $50 to $3,890Professionalmedian $105 · 10th to 90th $36 to $282
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 $25.70 Median $45.71 Typical High $14,454.40 | Facility | None | $25.70 | $45.71 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $45.71 Typical High $467.74 | Professional | None | $25.70 | $45.71 | $467.74 |
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 $43.65 Median $131.83 Typical High $295.12 | Professional | None | $43.65 | $131.83 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $117.49 Typical High $218.78 | Facility | None | $50.12 | $117.49 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $66.07 Typical High $162.18 | Professional | None | $33.88 | $66.07 | $162.18 |
DeanCare Setting Facility Modifier None Typical Low $27.54 Median $2,630.27 Typical High $5,128.61 | Facility | None | $27.54 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $154.88 | Professional | None | $52.48 | $85.11 | $154.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $812.83 Typical High $1,778.28 | Facility | None | $54.95 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $144.54 Typical High $316.23 | Professional | None | $56.23 | $144.54 | $316.23 |
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 $61.66 Median $112.20 Typical High $147.91 | Professional | None | $61.66 | $112.20 | $147.91 |
Prevea360 Setting Facility Modifier None Typical Low $25.12 Median $45.71 Typical High $87.10 | Facility | None | $25.12 | $45.71 | $87.10 |
Quartz Setting Professional Modifier None Typical Low $47.86 Median $95.50 Typical High $190.55 | Professional | None | $47.86 | $95.50 | $190.55 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $812.83 | Facility | None | $50.12 | $50.12 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $91.20 | Professional | None | $33.88 | $60.26 | $91.20 |
Security Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $229.09 | Professional | None | $128.82 | $128.82 | $229.09 |
Security Health Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $338.84 | Professional | None | $134.90 | $213.80 | $338.84 |
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 $35.48 Median $91.20 Typical High $190.55 | Professional | None | $35.48 | $91.20 | $190.55 |
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 $12.88 Median $12.88 Typical High $22.91 | Facility | 52 · Reduced service | $12.88 | $12.88 | $22.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $9.12 | Facility | 53 · Discontinued | $5.13 | $5.13 | $9.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $34.67 | Facility | 54 · Surgery only | $19.50 | $19.50 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $6.92 | Facility | 55 · Aftercare only | $3.89 | $3.89 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $4.57 | Facility | 56 · Pre-op care only | $2.57 | $2.57 | $4.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $22.91 Typical High $245.47 | Professional | 52 · Reduced service | $12.88 | $22.91 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $9.12 Typical High $97.72 | Professional | 53 · Discontinued | $5.13 | $9.12 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $34.67 Typical High $371.54 | Professional | 54 · Surgery only | $19.50 | $34.67 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.92 Typical High $74.13 | Professional | 55 · Aftercare only | $3.89 | $6.92 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.57 Typical High $48.98 | Professional | 56 · Pre-op care only | $2.57 | $4.57 | $48.98 |
Where Wisconsin sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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
$132
WI $132UT $38.90
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.