How much rates vary
Facilitymedian $1,202 · 10th to 90th $68 to $3,802Professionalmedian $170 · 10th to 90th $66 to $380
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 $51.29 Median $83.18 Typical High $14,454.40 | Facility | None | $51.29 | $83.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $371.54 | Professional | None | $51.29 | $83.18 | $371.54 |
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 $72.44 Median $208.93 Typical High $436.52 | Professional | None | $72.44 | $208.93 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $229.09 | Facility | None | $50.12 | $91.20 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $257.04 | Professional | None | $67.61 | $112.20 | $257.04 |
DeanCare Setting Facility Modifier None Typical Low $48.98 Median $2,630.27 Typical High $5,128.61 | Facility | None | $48.98 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $245.47 | Professional | None | $95.50 | $151.36 | $245.47 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $912.01 Typical High $1,778.28 | Facility | None | $85.11 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $204.17 Typical High $354.81 | Professional | None | $85.11 | $204.17 | $354.81 |
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 $107.15 Median $173.78 Typical High $213.80 | Professional | None | $107.15 | $173.78 | $213.80 |
Prevea360 Setting Facility Modifier None Typical Low $45.71 Median $69.18 Typical High $123.03 | Facility | None | $45.71 | $69.18 | $123.03 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $245.47 | Professional | None | $77.62 | $147.91 | $245.47 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $100.00 | Facility | None | $50.12 | $66.07 | $100.00 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $134.90 | Professional | None | $67.61 | $112.20 | $134.90 |
Security Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $186.21 | Professional | None | $112.20 | $112.20 | $186.21 |
Security Health Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $407.38 | Professional | None | $138.04 | $251.19 | $407.38 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $58.88 Median $147.91 Typical High $288.40 | Professional | None | $58.88 | $147.91 | $288.40 |
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 $25.70 Median $25.70 Typical High $41.69 | Facility | 52 · Reduced service | $25.70 | $25.70 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $16.98 | Facility | 53 · Discontinued | $10.23 | $10.23 | $16.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $63.10 | Facility | 54 · Surgery only | $38.02 | $38.02 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $12.59 | Facility | 55 · Aftercare only | $7.59 | $7.59 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $8.32 | Facility | 56 · Pre-op care only | $5.13 | $5.13 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $41.69 Typical High $251.19 | Professional | 52 · Reduced service | $25.70 | $41.69 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.98 Typical High $102.33 | Professional | 53 · Discontinued | $10.23 | $16.98 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $63.10 Typical High $380.19 | Professional | 54 · Surgery only | $38.02 | $63.10 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.59 Typical High $75.86 | Professional | 55 · Aftercare only | $7.59 | $12.59 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.32 Typical High $50.12 | Professional | 56 · Pre-op care only | $5.13 | $8.32 | $50.12 |
Where Wisconsin sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$200
WI $200DC $64.57
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.