How much rates vary
Facilitymedian $1,202 · 10th to 90th $158 to $3,802Professionalmedian $363 · 10th to 90th $141 to $759
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 $112.20 Median $173.78 Typical High $14,454.40 | Facility | None | $112.20 | $173.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $977.24 | Professional | None | $112.20 | $162.18 | $977.24 |
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 $158.49 Median $446.68 Typical High $891.25 | Professional | None | $158.49 | $446.68 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $398.11 Typical High $741.31 | Facility | None | $134.90 | $398.11 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $524.81 | Professional | None | $147.91 | $229.09 | $524.81 |
DeanCare Setting Facility Modifier None Typical Low $114.82 Median $2,630.27 Typical High $5,128.61 | Facility | None | $114.82 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $436.52 | Professional | None | $208.93 | $323.59 | $436.52 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $912.01 Typical High $1,778.28 | Facility | None | $151.36 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $426.58 Typical High $741.31 | Professional | None | $165.96 | $426.58 | $741.31 |
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 $218.78 Median $302.00 Typical High $436.52 | Professional | None | $218.78 | $302.00 | $436.52 |
Prevea360 Setting Facility Modifier None Typical Low $107.15 Median $165.96 Typical High $275.42 | Facility | None | $107.15 | $165.96 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $501.19 | Professional | None | $165.96 | $323.59 | $501.19 |
Quartz Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $831.76 | Facility | None | $131.83 | $199.53 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $288.40 | Professional | None | $147.91 | $229.09 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $380.19 | Professional | None | $245.47 | $245.47 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $831.76 | Professional | None | $354.81 | $537.03 | $831.76 |
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 $128.82 Median $323.59 Typical High $616.60 | Professional | None | $128.82 | $323.59 | $616.60 |
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 $56.23 Median $56.23 Typical High $85.11 | Facility | 52 · Reduced service | $56.23 | $56.23 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $34.67 | Facility | 53 · Discontinued | $22.39 | $22.39 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $128.82 | Facility | 54 · Surgery only | $85.11 | $85.11 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $25.70 | Facility | 55 · Aftercare only | $16.98 | $16.98 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $17.38 | Facility | 56 · Pre-op care only | $11.22 | $11.22 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $85.11 Typical High $537.03 | Professional | 52 · Reduced service | $56.23 | $85.11 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $34.67 Typical High $213.80 | Professional | 53 · Discontinued | $22.39 | $34.67 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $794.33 | Professional | 54 · Surgery only | $85.11 | $128.82 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $158.49 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.38 Typical High $107.15 | Professional | 56 · Pre-op care only | $11.22 | $17.38 | $107.15 |
Where Wisconsin sits
The same service costs 3.2 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
$417
WI $417KY $129
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.