How much rates vary
Facilitymedian $1,202 · 10th to 90th $95 to $3,890Professionalmedian $251 · 10th to 90th $93 to $550
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 $70.79 Median $114.82 Typical High $14,454.40 | Facility | None | $70.79 | $114.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $275.42 | Professional | None | $70.79 | $114.82 | $275.42 |
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 $100.00 Median $316.23 Typical High $588.84 | Professional | None | $100.00 | $316.23 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $131.83 Typical High $309.03 | Facility | None | $50.12 | $131.83 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $346.74 | Professional | None | $93.33 | $165.96 | $346.74 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $2,630.27 Typical High $5,128.61 | Facility | None | $72.44 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $346.74 | Professional | None | $131.83 | $213.80 | $346.74 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $912.01 Typical High $2,041.74 | Facility | None | $123.03 | $912.01 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $295.12 Typical High $489.78 | Professional | None | $123.03 | $295.12 | $489.78 |
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 $144.54 Median $245.47 Typical High $309.03 | Professional | None | $144.54 | $245.47 | $309.03 |
Prevea360 Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $181.97 | Facility | None | $67.61 | $109.65 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $346.74 | Professional | None | $109.65 | $218.78 | $346.74 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $95.50 Typical High $144.54 | Facility | None | $50.12 | $95.50 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $281.84 | Professional | None | $93.33 | $151.36 | $281.84 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
Security Health Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $549.54 | Professional | None | $245.47 | $346.74 | $549.54 |
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 $89.13 Median $218.78 Typical High $416.87 | Professional | None | $89.13 | $218.78 | $416.87 |
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 $35.48 Median $35.48 Typical High $56.23 | Facility | 52 · Reduced service | $35.48 | $35.48 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $22.91 | Facility | 53 · Discontinued | $14.13 | $14.13 | $22.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $85.11 | Facility | 54 · Surgery only | $52.48 | $52.48 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $16.98 | Facility | 55 · Aftercare only | $10.47 | $10.47 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $11.22 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $56.23 Typical High $338.84 | Professional | 52 · Reduced service | $35.48 | $56.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.91 Typical High $134.90 | Professional | 53 · Discontinued | $14.13 | $22.91 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $85.11 Typical High $512.86 | Professional | 54 · Surgery only | $52.48 | $85.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $102.33 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.22 Typical High $67.61 | Professional | 56 · Pre-op care only | $7.08 | $11.22 | $67.61 |
Where Wisconsin sits
The same service costs 3.0 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 $93.33
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.