How much rates vary
Facilitymedian $1,585 · 10th to 90th $174 to $4,266Professionalmedian $295 · 10th to 90th $112 to $724
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 $85.11 Median $173.78 Typical High $14,454.40 | Facility | None | $85.11 | $173.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $977.24 | Professional | None | $85.11 | $147.91 | $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 $138.04 Median $380.19 Typical High $794.33 | Professional | None | $138.04 | $380.19 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $398.11 Typical High $741.31 | Facility | None | $177.83 | $398.11 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $537.03 | Professional | None | $112.20 | $229.09 | $537.03 |
DeanCare Setting Facility Modifier None Typical Low $89.13 Median $2,570.40 Typical High $4,786.30 | Facility | None | $89.13 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $416.87 | Professional | None | $158.49 | $245.47 | $416.87 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $1,479.11 Typical High $3,890.45 | Facility | None | $169.82 | $1,479.11 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $407.38 Typical High $645.65 | Professional | None | $158.49 | $407.38 | $645.65 |
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 $169.82 Median $295.12 Typical High $446.68 | Professional | None | $169.82 | $295.12 | $446.68 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $151.36 Typical High $309.03 | Facility | None | $79.43 | $151.36 | $309.03 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $275.42 Typical High $501.19 | Professional | None | $147.91 | $275.42 | $501.19 |
Quartz Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $831.76 | Facility | None | $173.78 | $269.15 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $275.42 | Professional | None | $112.20 | $213.80 | $275.42 |
Security Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $389.05 | Professional | None | $181.97 | $181.97 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $218.78 Median $398.11 Typical High $831.76 | Professional | None | $218.78 | $398.11 | $831.76 |
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 $100.00 Median $257.04 Typical High $575.44 | Professional | None | $100.00 | $257.04 | $575.44 |
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 $42.66 Median $42.66 Typical High $85.11 | Facility | 52 · Reduced service | $42.66 | $42.66 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $34.67 | Facility | 53 · Discontinued | $16.98 | $16.98 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | 54 · Surgery only | $63.10 | $63.10 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $25.70 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $17.38 | Facility | 56 · Pre-op care only | $8.51 | $8.51 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $85.11 Typical High $501.19 | Professional | 52 · Reduced service | $42.66 | $85.11 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $34.67 Typical High $199.53 | Professional | 53 · Discontinued | $16.98 | $34.67 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $128.82 Typical High $758.58 | Professional | 54 · Surgery only | $63.10 | $128.82 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $25.70 Typical High $151.36 | Professional | 55 · Aftercare only | $12.59 | $25.70 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $17.38 Typical High $100.00 | Professional | 56 · Pre-op care only | $8.51 | $17.38 | $100.00 |
Where Wisconsin sits
The same service costs 3.3 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
$372
WI $372KY $112
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.