How much rates vary
Facilitymedian $1,380 · 10th to 90th $78 to $4,074Professionalmedian $166 · 10th to 90th $59 to $457
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 $41.69 Median $77.62 Typical High $14,454.40 | Facility | None | $41.69 | $77.62 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $602.56 | Professional | None | $41.69 | $77.62 | $602.56 |
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 $70.79 Median $213.80 Typical High $478.63 | Professional | None | $70.79 | $213.80 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $309.03 | Facility | None | $50.12 | $199.53 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $275.42 | Professional | None | $54.95 | $102.33 | $275.42 |
DeanCare Setting Facility Modifier None Typical Low $46.77 Median $2,570.40 Typical High $4,786.30 | Facility | None | $46.77 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $229.09 | Professional | None | $85.11 | $134.90 | $229.09 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $912.01 Typical High $1,995.26 | Facility | None | $109.65 | $912.01 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $645.65 | Professional | None | $81.28 | $223.87 | $645.65 |
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 $91.20 Median $162.18 Typical High $245.47 | Professional | None | $91.20 | $162.18 | $245.47 |
Prevea360 Setting Facility Modifier None Typical Low $36.31 Median $75.86 Typical High $154.88 | Facility | None | $36.31 | $75.86 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $288.40 | Professional | None | $79.43 | $162.18 | $288.40 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $134.90 | Professional | None | $54.95 | $102.33 | $134.90 |
Security Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $380.19 | Professional | None | $204.17 | $204.17 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $549.54 | Professional | None | $194.98 | $331.13 | $549.54 |
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 $51.29 Median $144.54 Typical High $295.12 | Professional | None | $51.29 | $144.54 | $295.12 |
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 $20.89 Median $20.89 Typical High $38.90 | Facility | 52 · Reduced service | $20.89 | $20.89 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $15.85 | Facility | 53 · Discontinued | $8.32 | $8.32 | $15.85 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $58.88 | Facility | 54 · Surgery only | $30.90 | $30.90 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $11.75 | Facility | 55 · Aftercare only | $6.31 | $6.31 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $7.76 | Facility | 56 · Pre-op care only | $4.17 | $4.17 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $38.90 Typical High $302.00 | Professional | 52 · Reduced service | $20.89 | $38.90 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.85 Typical High $120.23 | Professional | 53 · Discontinued | $8.32 | $15.85 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $58.88 Typical High $457.09 | Professional | 54 · Surgery only | $30.90 | $58.88 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.75 Typical High $91.20 | Professional | 55 · Aftercare only | $6.31 | $11.75 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.76 Typical High $60.26 | Professional | 56 · Pre-op care only | $4.17 | $7.76 | $60.26 |
Where Wisconsin sits
The same service costs 3.4 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
$209
WI $209KY $61.66
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.