How much rates vary
Facilitymedian $1,230 · 10th to 90th $93 to $3,802Professionalmedian $234 · 10th to 90th $85 to $562
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 $66.07 Median $93.33 Typical High $14,454.40 | Facility | None | $66.07 | $93.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $724.44 | Professional | None | $66.07 | $93.33 | $724.44 |
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 $100.00 Median $281.84 Typical High $588.84 | Professional | None | $100.00 | $281.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $234.42 Typical High $707.95 | Facility | None | $79.43 | $234.42 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $323.59 | Professional | None | $85.11 | $141.25 | $323.59 |
DeanCare Setting Facility Modifier None Typical Low $74.13 Median $2,570.40 Typical High $4,786.30 | Facility | None | $74.13 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $269.15 | Professional | None | $134.90 | $194.98 | $269.15 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $2,089.30 | Facility | None | $128.82 | $912.01 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $269.15 Typical High $562.34 | Professional | None | $100.00 | $269.15 | $562.34 |
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 |
Network Health Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $295.12 | Professional | None | $128.82 | $199.53 | $295.12 |
Prevea360 Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $181.97 | Facility | None | $57.54 | $93.33 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $346.74 | Professional | None | $100.00 | $199.53 | $346.74 |
Quartz Setting Facility Modifier None Typical Low $77.62 Median $117.49 Typical High $831.76 | Facility | None | $77.62 | $117.49 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $208.93 | Professional | None | $85.11 | $120.23 | $208.93 |
Security Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $457.09 | Professional | None | $323.59 | $323.59 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
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 $81.28 Median $208.93 Typical High $436.52 | Professional | None | $81.28 | $208.93 | $436.52 |
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 $33.11 Median $33.11 Typical High $45.71 | Facility | 52 · Reduced service | $33.11 | $33.11 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $18.62 | Facility | 53 · Discontinued | $13.18 | $13.18 | $18.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $69.18 | Facility | 54 · Surgery only | $48.98 | $48.98 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $13.80 | Facility | 55 · Aftercare only | $9.77 | $9.77 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $9.33 | Facility | 56 · Pre-op care only | $6.61 | $6.61 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $45.71 Typical High $363.08 | Professional | 52 · Reduced service | $33.11 | $45.71 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $18.62 Typical High $144.54 | Professional | 53 · Discontinued | $13.18 | $18.62 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $69.18 Typical High $549.54 | Professional | 54 · Surgery only | $48.98 | $69.18 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $109.65 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.33 Typical High $72.44 | Professional | 56 · Pre-op care only | $6.61 | $9.33 | $72.44 |
Where Wisconsin sits
The same service costs 3.5 times more in Wisconsin 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· 1st of 51
$269
WI $269FL $75.86
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.