How much rates vary
Facilitymedian $2,399 · 10th to 90th $468 to $5,754Professionalmedian $759 · 10th to 90th $275 to $1,905
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 $199.53 Median $346.74 Typical High $14,454.40 | Facility | None | $199.53 | $346.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $2,187.76 | Professional | None | $199.53 | $346.74 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,162.28 Typical High $6,025.60 | Facility | None | $1,445.44 | $3,162.28 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $1,000.00 Typical High $2,089.30 | Professional | None | $331.13 | $1,000.00 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $870.96 Typical High $1,348.96 | Facility | None | $524.81 | $870.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $1,202.26 | Professional | None | $263.03 | $467.74 | $1,202.26 |
DeanCare Setting Facility Modifier None Typical Low $275.42 Median $3,090.30 Typical High $5,370.32 | Facility | None | $275.42 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $912.01 | Professional | None | $416.87 | $645.65 | $912.01 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $2,041.74 Typical High $4,786.30 | Facility | None | $416.87 | $2,041.74 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $912.01 Typical High $1,862.09 | Professional | None | $346.74 | $912.01 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,174.90 | Professional | None | $446.68 | $630.96 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $194.98 Median $363.08 Typical High $676.08 | Facility | None | $194.98 | $363.08 | $676.08 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,174.90 | Professional | None | $363.08 | $691.83 | $1,174.90 |
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 $263.03 Median $446.68 Typical High $645.65 | Professional | None | $263.03 | $446.68 | $645.65 |
Security Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,862.09 | Professional | None | $977.24 | $977.24 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,570.40 | Professional | None | $954.99 | $1,479.11 | $2,570.40 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,677.35 | Facility | None | $707.95 | $2,754.23 | $4,677.35 |
United Setting Professional Modifier None Typical Low $251.19 Median $676.08 Typical High $1,380.38 | Professional | None | $251.19 | $676.08 | $1,380.38 |
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 $100.00 Median $100.00 Typical High $173.78 | Facility | 52 · Reduced service | $100.00 | $100.00 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | 53 · Discontinued | $39.81 | $39.81 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $257.04 | Facility | 54 · Surgery only | $151.36 | $151.36 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $51.29 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $34.67 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $173.78 Typical High $1,122.02 | Professional | 52 · Reduced service | $100.00 | $173.78 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $69.18 Typical High $446.68 | Professional | 53 · Discontinued | $39.81 | $69.18 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $257.04 Typical High $1,698.24 | Professional | 54 · Surgery only | $151.36 | $257.04 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $51.29 Typical High $338.84 | Professional | 55 · Aftercare only | $30.20 | $51.29 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $34.67 Typical High $223.87 | Professional | 56 · Pre-op care only | $19.95 | $34.67 | $223.87 |
Where Wisconsin sits
The same service costs 3.0 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
$891
WI $891KY $295
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.