How much rates vary
Facilitymedian $1,202 · 10th to 90th $112 to $3,802Professionalmedian $214 · 10th to 90th $74 to $589
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 $53.70 Median $102.33 Typical High $14,454.40 | Facility | None | $53.70 | $102.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $794.33 | Professional | None | $53.70 | $102.33 | $794.33 |
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 $93.33 Median $269.15 Typical High $616.60 | Professional | None | $93.33 | $269.15 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $263.03 Typical High $707.95 | Facility | None | $114.82 | $263.03 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $134.90 Typical High $354.81 | Professional | None | $70.79 | $134.90 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $57.54 Median $2,630.27 Typical High $5,128.61 | Facility | None | $57.54 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $295.12 | Professional | None | $109.65 | $173.78 | $295.12 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $912.01 Typical High $1,778.28 | Facility | None | $107.15 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $295.12 Typical High $616.60 | Professional | None | $114.82 | $295.12 | $616.60 |
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 $114.82 Median $199.53 Typical High $323.59 | Professional | None | $114.82 | $199.53 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $181.97 | Facility | None | $52.48 | $100.00 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $380.19 | Professional | None | $102.33 | $213.80 | $380.19 |
Quartz Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $831.76 | Facility | None | $112.20 | $169.82 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $134.90 Typical High $177.83 | Professional | None | $70.79 | $134.90 | $177.83 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $501.19 | Professional | None | $263.03 | $263.03 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $724.44 | Professional | None | $251.19 | $426.58 | $724.44 |
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 $70.79 Median $190.55 Typical High $407.38 | Professional | None | $70.79 | $190.55 | $407.38 |
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 $26.92 Median $26.92 Typical High $51.29 | Facility | 52 · Reduced service | $26.92 | $26.92 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $20.42 | Facility | 53 · Discontinued | $10.72 | $10.72 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $75.86 | Facility | 54 · Surgery only | $40.74 | $40.74 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $15.14 | Facility | 55 · Aftercare only | $8.13 | $8.13 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $10.23 | Facility | 56 · Pre-op care only | $5.37 | $5.37 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $51.29 Typical High $426.58 | Professional | 52 · Reduced service | $26.92 | $51.29 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $20.42 Typical High $169.82 | Professional | 53 · Discontinued | $10.72 | $20.42 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $75.86 Typical High $630.96 | Professional | 54 · Surgery only | $40.74 | $75.86 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $15.14 Typical High $125.89 | Professional | 55 · Aftercare only | $8.13 | $15.14 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.23 Typical High $85.11 | Professional | 56 · Pre-op care only | $5.37 | $10.23 | $85.11 |
Where Wisconsin sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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
$257
WI $257KY $91.20
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.