How much rates vary
Facilitymedian $1,202 · 10th to 90th $102 to $3,802Professionalmedian $204 · 10th to 90th $81 to $447
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 $63.10 Median $102.33 Typical High $14,454.40 | Facility | None | $63.10 | $102.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $562.34 | Professional | None | $63.10 | $100.00 | $562.34 |
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 $91.20 Median $257.04 Typical High $537.03 | Professional | None | $91.20 | $257.04 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $239.88 Typical High $707.95 | Facility | None | $85.11 | $239.88 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $316.23 | Professional | None | $83.18 | $138.04 | $316.23 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $2,630.27 Typical High $5,128.61 | Facility | None | $64.57 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $275.42 | Professional | None | $117.49 | $190.55 | $275.42 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $912.01 Typical High $1,778.28 | Facility | None | $109.65 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $269.15 Typical High $426.58 | Professional | None | $102.33 | $269.15 | $426.58 |
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 $131.83 Median $194.98 Typical High $263.03 | Professional | None | $131.83 | $194.98 | $263.03 |
Prevea360 Setting Facility Modifier None Typical Low $61.66 Median $100.00 Typical High $169.82 | Facility | None | $61.66 | $100.00 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $309.03 | Professional | None | $102.33 | $186.21 | $309.03 |
Quartz Setting Facility Modifier None Typical Low $83.18 Median $128.82 Typical High $831.76 | Facility | None | $83.18 | $128.82 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $165.96 | Professional | None | $83.18 | $138.04 | $165.96 |
Security Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $117.49 | Professional | None | $74.13 | $74.13 | $117.49 |
Security Health Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $588.84 | Professional | None | $61.66 | $120.23 | $588.84 |
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 $74.13 Median $186.21 Typical High $380.19 | Professional | None | $74.13 | $186.21 | $380.19 |
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 $31.62 Median $31.62 Typical High $51.29 | Facility | 52 · Reduced service | $31.62 | $31.62 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $20.89 | Facility | 53 · Discontinued | $12.59 | $12.59 | $20.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $77.62 | Facility | 54 · Surgery only | $47.86 | $47.86 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $15.49 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $10.23 | Facility | 56 · Pre-op care only | $6.31 | $6.31 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $51.29 Typical High $338.84 | Professional | 52 · Reduced service | $31.62 | $51.29 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $20.89 Typical High $134.90 | Professional | 53 · Discontinued | $12.59 | $20.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $77.62 Typical High $512.86 | Professional | 54 · Surgery only | $47.86 | $77.62 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $15.49 Typical High $102.33 | Professional | 55 · Aftercare only | $9.55 | $15.49 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $6.31 | $10.23 | $67.61 |
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
$240
WI $240DC $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.