How much rates vary
Facilitymedian $3,090 · 10th to 90th $468 to $8,913Professionalmedian $234 · 10th to 90th $85 to $407
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 $85.11 Median $1,905.46 Typical High $14,454.40 | Facility | None | $85.11 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $1,380.38 | Professional | None | $85.11 | $85.11 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $6,760.83 Typical High $11,481.54 | Facility | None | $2,041.74 | $6,760.83 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $257.04 Typical High $457.09 | Professional | None | $91.20 | $257.04 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $389.05 Typical High $676.08 | Professional | 50 · Both sides | $141.25 | $389.05 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $776.25 Typical High $3,162.28 | Facility | None | $194.98 | $776.25 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $281.84 | Professional | None | $102.33 | $165.96 | $281.84 |
DeanCare Setting Facility Modifier None Typical Low $87.10 Median $2,754.23 Typical High $5,128.61 | Facility | None | $87.10 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $245.47 | Professional | None | $131.83 | $194.98 | $245.47 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $2,398.83 Typical High $6,760.83 | Facility | None | $575.44 | $2,398.83 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $239.88 Typical High $436.52 | Professional | None | $87.10 | $239.88 | $436.52 |
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 $109.65 Median $186.21 Typical High $245.47 | Professional | None | $109.65 | $186.21 | $245.47 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $575.44 | Facility | None | $79.43 | $100.00 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $74.13 Median $169.82 Typical High $316.23 | Professional | None | $74.13 | $169.82 | $316.23 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $2,089.30 Typical High $3,467.37 | Facility | None | $537.03 | $2,089.30 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $245.47 | Professional | None | $102.33 | $102.33 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Security Health Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $380.19 | Professional | None | $218.78 | $331.13 | $380.19 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $72.44 Median $218.78 Typical High $398.11 | Professional | None | $72.44 | $218.78 | $398.11 |
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 $42.66 Median $42.66 Typical High $691.83 | Professional | 52 · Reduced service | $42.66 | $42.66 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $275.42 | Professional | 53 · Discontinued | $16.98 | $16.98 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $1,023.29 | Professional | 54 · Surgery only | $63.10 | $63.10 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $208.93 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $138.04 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $138.04 |
Where Wisconsin sits
The same service costs 11.2 times more in Tennessee than in New York. 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· 8th of 51
$316
TN $832NY $74.13
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.