How much rates vary
Facilitymedian $1,622 · 10th to 90th $407 to $4,365Professionalmedian $724 · 10th to 90th $234 to $2,291
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 $169.82 Median $380.19 Typical High $14,454.40 | Facility | None | $169.82 | $380.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $380.19 Typical High $2,511.89 | Professional | None | $169.82 | $380.19 | $2,511.89 |
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 $309.03 Median $933.25 Typical High $2,290.87 | Professional | None | $309.03 | $933.25 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,380.38 | Facility | None | $524.81 | $891.25 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $1,412.54 | Professional | None | $223.87 | $489.78 | $1,412.54 |
DeanCare Setting Facility Modifier None Typical Low $199.53 Median $3,090.30 Typical High $5,370.32 | Facility | None | $199.53 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $1,202.26 | Professional | None | $346.74 | $549.54 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,479.11 Typical High $3,630.78 | Facility | None | $398.11 | $1,479.11 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,202.26 Typical High $2,454.71 | Professional | None | $426.58 | $1,202.26 | $2,454.71 |
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 $371.54 Median $724.44 Typical High $1,288.25 | Professional | None | $371.54 | $724.44 | $1,288.25 |
Prevea360 Setting Facility Modifier None Typical Low $165.96 Median $331.13 Typical High $575.44 | Facility | None | $165.96 | $331.13 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $323.59 Median $691.83 Typical High $1,548.82 | Professional | None | $323.59 | $691.83 | $1,548.82 |
Quartz Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $1,122.02 | Facility | None | $512.86 | $676.08 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $676.08 | Professional | None | $223.87 | $489.78 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $2,041.74 | Professional | None | $831.76 | $831.76 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $3,019.95 | Professional | None | $891.25 | $1,659.59 | $3,019.95 |
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 $218.78 Median $616.60 Typical High $1,698.24 | Professional | None | $218.78 | $616.60 | $1,698.24 |
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 $85.11 Median $85.11 Typical High $190.55 | Facility | 52 · Reduced service | $85.11 | $85.11 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $75.86 | Facility | 53 · Discontinued | $33.88 | $33.88 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $281.84 | Facility | 54 · Surgery only | $128.82 | $128.82 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $56.23 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $38.02 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $38.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $190.55 Typical High $1,258.93 | Professional | 52 · Reduced service | $85.11 | $190.55 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $75.86 Typical High $501.19 | Professional | 53 · Discontinued | $33.88 | $75.86 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $281.84 Typical High $1,862.09 | Professional | 54 · Surgery only | $128.82 | $281.84 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $56.23 Typical High $380.19 | Professional | 55 · Aftercare only | $25.70 | $56.23 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $38.02 Typical High $251.19 | Professional | 56 · Pre-op care only | $16.98 | $38.02 | $251.19 |
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
$871
WI $871KY $309
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.