How much rates vary
Facilitymedian $1,000 · 10th to 90th $43 to $2,344Professionalmedian $100 · 10th to 90th $38 to $209
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 $32.36 Median $42.66 Typical High $14,454.40 | Facility | None | $32.36 | $42.66 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $380.19 | Professional | None | $32.36 | $41.69 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $123.03 Typical High $218.78 | Professional | None | $43.65 | $123.03 | $218.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $26.92 Median $77.62 Typical High $138.04 | Professional | 62 · Two surgeons | $26.92 | $77.62 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $114.82 Typical High $831.76 | Facility | None | $97.72 | $114.82 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $128.82 | Professional | None | $42.66 | $60.26 | $128.82 |
DeanCare Setting Facility Modifier None Typical Low $33.11 Median $2,630.27 Typical High $5,128.61 | Facility | None | $33.11 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $123.03 | Professional | None | $60.26 | $87.10 | $123.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $812.83 Typical High $1,778.28 | Facility | None | $54.95 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $120.23 Typical High $457.09 | Professional | None | $44.67 | $120.23 | $457.09 |
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 $54.95 Median $85.11 Typical High $112.20 | Professional | None | $54.95 | $85.11 | $112.20 |
Prevea360 Setting Facility Modifier None Typical Low $30.90 Median $40.74 Typical High $75.86 | Facility | None | $30.90 | $40.74 | $75.86 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $125.89 | Professional | None | $43.65 | $87.10 | $125.89 |
Quartz Setting Facility Modifier None Typical Low $446.68 Median $707.95 Typical High $2,691.53 | Facility | None | $446.68 | $707.95 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $83.18 | Professional | None | $42.66 | $56.23 | $83.18 |
Security Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | None | $70.79 | $70.79 | $93.33 |
Security Health Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $208.93 | Professional | None | $93.33 | $154.88 | $208.93 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $36.31 Median $93.33 Typical High $162.18 | Professional | None | $36.31 | $93.33 | $162.18 |
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 $16.22 Median $16.22 Typical High $21.38 | Facility | 52 · Reduced service | $16.22 | $16.22 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $8.51 | Facility | 53 · Discontinued | $6.46 | $6.46 | $8.51 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $23.99 Median $23.99 Typical High $32.36 | Facility | 54 · Surgery only | $23.99 | $23.99 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $6.46 | Facility | 55 · Aftercare only | $4.79 | $4.79 | $6.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $4.27 | Facility | 56 · Pre-op care only | $3.24 | $3.24 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $21.38 Typical High $194.98 | Professional | 52 · Reduced service | $16.22 | $21.38 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.51 Typical High $77.62 | Professional | 53 · Discontinued | $6.46 | $8.51 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $32.36 Typical High $295.12 | Professional | 54 · Surgery only | $23.99 | $32.36 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.46 Typical High $58.88 | Professional | 55 · Aftercare only | $4.79 | $6.46 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.27 Typical High $38.90 | Professional | 56 · Pre-op care only | $3.24 | $4.27 | $38.90 |
Where Wisconsin sits
The same service costs 3.3 times more in Alaska 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· 2nd of 51
$112
AK $117KY $35.48
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.