How much rates vary
Facilitymedian $5,495 · 10th to 90th $912 to $15,136Professionalmedian $12,023 · 10th to 90th $4,677 to $22,387
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 $4,897.79 Median $4,897.79 Typical High $14,454.40 | Facility | None | $4,897.79 | $4,897.79 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,786.30 Median $13,803.84 Typical High $25,118.86 | Professional | None | $4,786.30 | $13,803.84 | $25,118.86 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,786.30 | Facility | None | $812.83 | $2,884.03 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $6,456.54 Typical High $14,125.38 | Professional | None | $5,495.41 | $6,456.54 | $14,125.38 |
DeanCare Setting Facility Modifier None Typical Low $5,011.87 Median $7,943.28 Typical High $14,791.08 | Facility | None | $5,011.87 | $7,943.28 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,951.21 Typical High $19,054.61 | Facility | None | $436.52 | $2,951.21 | $19,054.61 |
Medica Setting Professional Modifier None Typical Low $4,466.84 Median $11,481.54 Typical High $19,498.45 | Professional | None | $4,466.84 | $11,481.54 | $19,498.45 |
Prevea360 Setting Facility Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $8,511.38 | Facility | None | $4,466.84 | $4,677.35 | $8,511.38 |
Quartz Setting Professional Modifier None Typical Low $4,466.84 Median $9,332.54 Typical High $13,182.57 | Professional | None | $4,466.84 | $9,332.54 | $13,182.57 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,786.30 | Facility | None | $812.83 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $11,481.54 | Professional | None | $5,495.41 | $5,495.41 | $11,481.54 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $10,471.29 Typical High $17,782.79 | Professional | None | $4,073.80 | $10,471.29 | $17,782.79 |
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $489.78 | $489.78 | $489.78 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 3rd of 51
$8,511
AK $14,125AR $3,236
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.