How much rates vary
Facilitymedian $1,380 · 10th to 90th $120 to $4,074Professionalmedian $200 · 10th to 90th $74 to $501
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 $57.54 Median $125.89 Typical High $14,454.40 | Facility | None | $57.54 | $125.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $446.68 | Professional | None | $57.54 | $104.71 | $446.68 |
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 $95.50 Median $251.19 Typical High $549.54 | Professional | None | $95.50 | $251.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $288.40 Typical High $446.68 | Facility | None | $50.12 | $288.40 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $165.96 Typical High $380.19 | Professional | None | $75.86 | $165.96 | $380.19 |
DeanCare Setting Facility Modifier None Typical Low $58.88 Median $2,630.27 Typical High $5,128.61 | Facility | None | $58.88 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $302.00 | Professional | None | $107.15 | $173.78 | $302.00 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $912.01 Typical High $1,778.28 | Facility | None | $120.23 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $234.42 Typical High $457.09 | Professional | None | $93.33 | $234.42 | $457.09 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $323.59 | Professional | None | $114.82 | $162.18 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $162.18 | Facility | None | $54.95 | $100.00 | $162.18 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $346.74 | Professional | None | $97.72 | $169.82 | $346.74 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $194.98 | Professional | None | $75.86 | $147.91 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $281.84 | Professional | None | $125.89 | $125.89 | $281.84 |
Security Health Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $602.56 | Professional | None | $141.25 | $281.84 | $602.56 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $66.07 Median $181.97 Typical High $331.13 | Professional | None | $66.07 | $181.97 | $331.13 |
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 $28.84 Median $28.84 Typical High $63.10 | Facility | 52 · Reduced service | $28.84 | $28.84 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $25.12 | Facility | 53 · Discontinued | $11.48 | $11.48 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $93.33 | Facility | 54 · Surgery only | $43.65 | $43.65 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $18.62 | Facility | 55 · Aftercare only | $8.71 | $8.71 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $12.59 | Facility | 56 · Pre-op care only | $5.75 | $5.75 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $63.10 Typical High $309.03 | Professional | 52 · Reduced service | $28.84 | $63.10 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $25.12 Typical High $123.03 | Professional | 53 · Discontinued | $11.48 | $25.12 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $93.33 Typical High $467.74 | Professional | 54 · Surgery only | $43.65 | $93.33 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $18.62 Typical High $93.33 | Professional | 55 · Aftercare only | $8.71 | $18.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $12.59 Typical High $61.66 | Professional | 56 · Pre-op care only | $5.75 | $12.59 | $61.66 |
Where Wisconsin sits
The same service costs 3.2 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· 3rd of 51
$234
AK $251NY $77.62
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.