How much rates vary
Facilitymedian $1,585 · 10th to 90th $191 to $4,266Professionalmedian $490 · 10th to 90th $186 to $933
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 $162.18 Median $204.17 Typical High $14,454.40 | Facility | None | $162.18 | $204.17 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $1,659.59 | Professional | None | $162.18 | $204.17 | $1,659.59 |
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 $204.17 Median $562.34 Typical High $977.24 | Professional | None | $204.17 | $562.34 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $128.82 Median $371.54 Typical High $616.60 | Professional | 62 · Two surgeons | $128.82 | $371.54 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $467.74 Typical High $794.33 | Facility | None | $151.36 | $467.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $645.65 | Professional | None | $190.55 | $288.40 | $645.65 |
DeanCare Setting Facility Modifier None Typical Low $154.88 Median $2,630.27 Typical High $5,128.61 | Facility | None | $154.88 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $575.44 | Professional | None | $302.00 | $426.58 | $575.44 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $1,412.54 Typical High $3,019.95 | Facility | None | $229.09 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $1,047.13 | Professional | None | $204.17 | $562.34 | $1,047.13 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $588.84 | Professional | None | $263.03 | $446.68 | $588.84 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $346.74 | Facility | None | $128.82 | $190.55 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $426.58 Typical High $616.60 | Professional | None | $204.17 | $426.58 | $616.60 |
Quartz Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $831.76 | Facility | None | $147.91 | $229.09 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $467.74 | Professional | None | $190.55 | $245.47 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $478.63 | Professional | None | $380.19 | $380.19 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $870.96 | Professional | None | $489.78 | $676.08 | $870.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,548.13 | Facility | None | $512.86 | $2,238.72 | $3,548.13 |
United Setting Professional Modifier None Typical Low $173.78 Median $457.09 Typical High $794.33 | Professional | None | $173.78 | $457.09 | $794.33 |
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 $79.43 Median $79.43 Typical High $102.33 | Facility | 52 · Reduced service | $79.43 | $79.43 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $40.74 | Facility | 53 · Discontinued | $32.36 | $32.36 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $154.88 | Facility | 54 · Surgery only | $120.23 | $120.23 | $154.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.90 | Facility | 55 · Aftercare only | $23.99 | $23.99 | $30.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $20.42 | Facility | 56 · Pre-op care only | $16.22 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $102.33 Typical High $831.76 | Professional | 52 · Reduced service | $79.43 | $102.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $331.13 | Professional | 53 · Discontinued | $32.36 | $40.74 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $154.88 Typical High $1,258.93 | Professional | 54 · Surgery only | $120.23 | $154.88 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $251.19 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $165.96 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $165.96 |
Where Wisconsin sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 2nd of 51
$550
AK $575PA $170
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.