How much rates vary
Facilitymedian $1,318 · 10th to 90th $178 to $3,981Professionalmedian $76 · 10th to 90th $30 to $257
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 $58.88 Median $1,905.46 Typical High $14,454.40 | Facility | None | $58.88 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $1,584.89 | Professional | None | $58.88 | $58.88 | $1,584.89 |
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 $26.92 Median $81.28 Typical High $302.00 | Professional | None | $26.92 | $81.28 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $1,071.52 | Facility | None | $154.88 | $257.04 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $123.03 | Professional | None | $64.57 | $72.44 | $123.03 |
DeanCare Setting Facility Modifier None Typical Low $42.66 Median $3,162.28 Typical High $5,888.44 | Facility | None | $42.66 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $158.49 | Professional | None | $97.72 | $97.72 | $158.49 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $812.83 Typical High $1,778.28 | Facility | None | $120.23 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $69.18 Typical High $144.54 | Professional | None | $25.12 | $69.18 | $144.54 |
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 |
Prevea360 Setting Facility Modifier None Typical Low $34.67 Median $50.12 Typical High $75.86 | Facility | None | $34.67 | $50.12 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $57.54 Median $112.20 Typical High $173.78 | Professional | None | $57.54 | $112.20 | $173.78 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $1,479.11 | Facility | None | $223.87 | $346.74 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Security Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $25.12 Median $72.44 Typical High $131.83 | Professional | None | $25.12 | $72.44 | $131.83 |
5 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 Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $794.33 | Professional | 52 · Reduced service | $29.51 | $29.51 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $316.23 | Professional | 53 · Discontinued | $11.75 | $11.75 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $1,202.26 | Professional | 54 · Surgery only | $43.65 | $43.65 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $239.88 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $158.49 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $158.49 |
Where Wisconsin sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 15th of 51
$129
TN $288ME $31.62
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.