How much rates vary
Facilitymedian $1,778 · 10th to 90th $98 to $4,467Professionalmedian $141 · 10th to 90th $59 to $575
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 $44.67 Median $93.33 Typical High $14,454.40 | Facility | None | $44.67 | $93.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $93.33 Typical High $891.25 | Professional | None | $44.67 | $93.33 | $891.25 |
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 $63.10 Median $190.55 Typical High $562.34 | Professional | None | $63.10 | $190.55 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $123.03 | Professional | None | $79.43 | $81.28 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $269.15 Typical High $398.11 | Facility | None | $234.42 | $269.15 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $239.88 | Professional | None | $58.88 | $120.23 | $239.88 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $2,754.23 Typical High $5,128.61 | Facility | None | $64.57 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $234.42 | Professional | None | $74.13 | $154.88 | $234.42 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $1,380.38 Typical High $1,778.28 | Facility | None | $85.11 | $1,380.38 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $346.74 Typical High $1,778.28 | Professional | None | $117.49 | $346.74 | $1,778.28 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,344.23 | Facility | None | $831.76 | $1,819.70 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $288.40 | Professional | None | $141.25 | $223.87 | $288.40 |
Prevea360 Setting Facility Modifier None Typical Low $46.77 Median $85.11 Typical High $162.18 | Facility | None | $46.77 | $85.11 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $316.23 | Professional | None | $64.57 | $162.18 | $316.23 |
Quartz Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $141.25 | Professional | None | $58.88 | $120.23 | $141.25 |
Security Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $457.09 | Professional | None | $223.87 | $223.87 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $616.60 | Professional | None | $251.19 | $389.05 | $616.60 |
The Alliance Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $660.69 | Professional | None | $169.82 | $363.08 | $660.69 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $56.23 Median $134.90 Typical High $346.74 | Professional | None | $56.23 | $134.90 | $346.74 |
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 $22.39 Median $22.39 Typical High $46.77 | Facility | 52 · Reduced service | $22.39 | $22.39 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $18.62 | Facility | 53 · Discontinued | $8.91 | $8.91 | $18.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $69.18 | Facility | 54 · Surgery only | $33.88 | $33.88 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $13.80 | Facility | 55 · Aftercare only | $6.76 | $6.76 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $9.33 | Facility | 56 · Pre-op care only | $4.47 | $4.47 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $46.77 Typical High $457.09 | Professional | 52 · Reduced service | $22.39 | $46.77 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $18.62 Typical High $181.97 | Professional | 53 · Discontinued | $8.91 | $18.62 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $69.18 Typical High $676.08 | Professional | 54 · Surgery only | $33.88 | $69.18 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $13.80 Typical High $134.90 | Professional | 55 · Aftercare only | $6.76 | $13.80 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $9.33 Typical High $91.20 | Professional | 56 · Pre-op care only | $4.47 | $9.33 | $91.20 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $37.15 Median $77.62 Typical High $117.49 | Professional | 51 · Multiple procedures | $37.15 | $77.62 | $117.49 |
Where Wisconsin sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 3rd of 51
$151
NC $174FL $70.79
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.