How much rates vary
Facilitymedian $1,585 · 10th to 90th $117 to $4,266Professionalmedian $240 · 10th to 90th $93 to $513
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 $72.44 Median $117.49 Typical High $14,454.40 | Facility | None | $72.44 | $117.49 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $660.69 | Professional | None | $72.44 | $102.33 | $660.69 |
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 $102.33 Median $288.40 Typical High $588.84 | Professional | None | $102.33 | $288.40 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $269.15 Typical High $707.95 | Facility | None | $97.72 | $269.15 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $354.81 | Professional | None | $97.72 | $154.88 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $2,570.40 Typical High $4,786.30 | Facility | None | $79.43 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $288.40 | Professional | None | $138.04 | $218.78 | $288.40 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $1,479.11 Typical High $3,019.95 | Facility | None | $120.23 | $1,479.11 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $281.84 Typical High $758.58 | Professional | None | $109.65 | $281.84 | $758.58 |
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 $147.91 Median $199.53 Typical High $302.00 | Professional | None | $147.91 | $199.53 | $302.00 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $208.93 | Facility | None | $69.18 | $112.20 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $346.74 | Professional | None | $117.49 | $213.80 | $346.74 |
Quartz Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $831.76 | Facility | None | $97.72 | $147.91 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $186.21 | Professional | None | $97.72 | $154.88 | $186.21 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $257.04 | Professional | None | $158.49 | $158.49 | $257.04 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $562.34 | Professional | None | $194.98 | $346.74 | $562.34 |
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 $83.18 Median $208.93 Typical High $398.11 | Professional | None | $83.18 | $208.93 | $398.11 |
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 $36.31 Median $36.31 Typical High $58.88 | Facility | 52 · Reduced service | $36.31 | $36.31 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $23.44 | Facility | 53 · Discontinued | $14.79 | $14.79 | $23.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $87.10 | Facility | 54 · Surgery only | $54.95 | $54.95 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $17.38 | Facility | 55 · Aftercare only | $10.96 | $10.96 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $11.75 | Facility | 56 · Pre-op care only | $7.41 | $7.41 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $58.88 Typical High $346.74 | Professional | 52 · Reduced service | $36.31 | $58.88 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $23.44 Typical High $138.04 | Professional | 53 · Discontinued | $14.79 | $23.44 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $87.10 Typical High $524.81 | Professional | 54 · Surgery only | $54.95 | $87.10 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $17.38 Typical High $104.71 | Professional | 55 · Aftercare only | $10.96 | $17.38 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.75 Typical High $69.18 | Professional | 56 · Pre-op care only | $7.41 | $11.75 | $69.18 |
Where Wisconsin sits
The same service costs 3.6 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
$282
WI $282KY $77.62
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.