How much rates vary
Facilitymedian $1,950 · 10th to 90th $282 to $4,365Professionalmedian $309 · 10th to 90th $112 to $813
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 $83.18 Median $141.25 Typical High $14,454.40 | Facility | None | $83.18 | $141.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $1,148.15 | Professional | None | $83.18 | $141.25 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $398.11 Typical High $851.14 | Professional | None | $128.82 | $398.11 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $891.25 | Facility | None | $363.08 | $549.54 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $501.19 | Professional | None | $109.65 | $208.93 | $501.19 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $2,570.40 Typical High $4,786.30 | Facility | None | $117.49 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $416.87 | Professional | None | $169.82 | $263.03 | $416.87 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $1,479.11 Typical High $3,630.78 | Facility | None | $251.19 | $1,479.11 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $380.19 Typical High $870.96 | Professional | None | $134.90 | $380.19 | $870.96 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $457.09 | Professional | None | $177.83 | $245.47 | $457.09 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $147.91 Typical High $281.84 | Facility | None | $79.43 | $147.91 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $537.03 | Professional | None | $154.88 | $295.12 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $457.09 Median $645.65 Typical High $954.99 | Facility | None | $457.09 | $645.65 | $954.99 |
Quartz Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $263.03 | Professional | None | $109.65 | $186.21 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | None | $407.38 | $407.38 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,000.00 | Professional | None | $426.58 | $602.56 | $1,000.00 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $107.15 Median $281.84 Typical High $562.34 | Professional | None | $107.15 | $281.84 | $562.34 |
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 $41.69 Median $41.69 Typical High $70.79 | Facility | 52 · Reduced service | $41.69 | $41.69 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $28.18 | Facility | 53 · Discontinued | $16.60 | $16.60 | $28.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $107.15 | Facility | 54 · Surgery only | $61.66 | $61.66 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $21.38 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $14.13 | Facility | 56 · Pre-op care only | $8.32 | $8.32 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $70.79 Typical High $588.84 | Professional | 52 · Reduced service | $41.69 | $70.79 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $28.18 Typical High $234.42 | Professional | 53 · Discontinued | $16.60 | $28.18 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $107.15 Typical High $891.25 | Professional | 54 · Surgery only | $61.66 | $107.15 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $21.38 Typical High $177.83 | Professional | 55 · Aftercare only | $12.59 | $21.38 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $14.13 Typical High $117.49 | Professional | 56 · Pre-op care only | $8.32 | $14.13 | $117.49 |
Where Wisconsin sits
The same service costs 3.6 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
$417
WI $417KY $115
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.