How much rates vary
Facilitymedian $2,570 · 10th to 90th $468 to $5,754Professionalmedian $1,023 · 10th to 90th $389 to $2,138
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 $331.13 Median $467.74 Typical High $14,454.40 | Facility | None | $331.13 | $467.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $3,388.44 | Professional | None | $331.13 | $467.74 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,258.93 Typical High $2,290.87 | Professional | None | $457.09 | $1,258.93 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $794.33 Typical High $1,445.44 | Professional | 62 · Two surgeons | $288.40 | $794.33 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $5,754.40 | Facility | None | $954.99 | $1,819.70 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,380.38 | Professional | None | $436.52 | $616.60 | $1,380.38 |
DeanCare Setting Facility Modifier None Typical Low $338.84 Median $2,630.27 Typical High $5,128.61 | Facility | None | $338.84 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,122.02 | Professional | None | $630.96 | $851.14 | $1,122.02 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $537.03 Typical High $707.95 | Professional | 62 · Two surgeons | $398.11 | $537.03 | $707.95 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,548.82 Typical High $4,786.30 | Facility | None | $407.38 | $1,548.82 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,174.90 Typical High $4,897.79 | Professional | None | $467.74 | $1,174.90 | $4,897.79 |
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 $602.56 Median $870.96 Typical High $1,174.90 | Professional | None | $602.56 | $870.96 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $309.03 Median $446.68 Typical High $741.31 | Facility | None | $309.03 | $446.68 | $741.31 |
Quartz Setting Professional Modifier None Typical Low $436.52 Median $912.01 Typical High $1,380.38 | Professional | None | $436.52 | $912.01 | $1,380.38 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $3,801.89 Typical High $6,309.57 | Facility | None | $812.83 | $3,801.89 | $6,309.57 |
Quartz Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $912.01 | Professional | None | $436.52 | $616.60 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $977.24 | Professional | None | $707.95 | $707.95 | $977.24 |
Security Health Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $2,187.76 | Professional | None | $870.96 | $1,548.82 | $2,187.76 |
The Alliance Setting Professional Modifier None Typical Low $501.19 Median $1,412.54 Typical High $1,949.84 | Professional | None | $501.19 | $1,412.54 | $1,949.84 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
United Setting Professional Modifier None Typical Low $363.08 Median $933.25 Typical High $1,659.59 | Professional | None | $363.08 | $933.25 | $1,659.59 |
11 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 $165.96 Median $165.96 Typical High $234.42 | Facility | 52 · Reduced service | $165.96 | $165.96 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $93.33 | Facility | 53 · Discontinued | $66.07 | $66.07 | $93.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $346.74 | Facility | 54 · Surgery only | $251.19 | $251.19 | $346.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $70.79 | Facility | 55 · Aftercare only | $50.12 | $50.12 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $46.77 | Facility | 56 · Pre-op care only | $33.11 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $234.42 Typical High $1,698.24 | Professional | 52 · Reduced service | $165.96 | $234.42 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $93.33 Typical High $676.08 | Professional | 53 · Discontinued | $66.07 | $93.33 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $346.74 Typical High $2,511.89 | Professional | 54 · Surgery only | $251.19 | $346.74 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $70.79 Typical High $501.19 | Professional | 55 · Aftercare only | $50.12 | $70.79 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $46.77 Typical High $338.84 | Professional | 56 · Pre-op care only | $33.11 | $46.77 | $338.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $426.58 Typical High $562.34 | Professional | 51 · Multiple procedures | $316.23 | $426.58 | $562.34 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska 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· 2nd of 51
$1,122
AK $1,380NY $355
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.