How much rates vary
Facilitymedian $1,585 · 10th to 90th $145 to $4,365Professionalmedian $347 · 10th to 90th $148 to $589
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 $147.91 Median $181.97 Typical High $14,454.40 | Facility | None | $147.91 | $181.97 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $2,137.96 | Professional | None | $141.25 | $169.82 | $2,137.96 |
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 $151.36 Median $380.19 Typical High $537.03 | Professional | None | $151.36 | $380.19 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $165.96 Typical High $457.09 | Facility | None | $50.12 | $165.96 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $512.86 | Professional | None | $173.78 | $245.47 | $512.86 |
DeanCare Setting Facility Modifier None Typical Low $144.54 Median $2,630.27 Typical High $5,128.61 | Facility | None | $144.54 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $512.86 | Professional | None | $263.03 | $363.08 | $512.86 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $1,412.54 Typical High $3,019.95 | Facility | None | $229.09 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $933.25 | Professional | None | $177.83 | $436.52 | $933.25 |
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 $218.78 Median $363.08 Typical High $426.58 | Professional | None | $218.78 | $363.08 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $302.00 | Facility | None | $134.90 | $177.83 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $371.54 Typical High $524.81 | Professional | None | $186.21 | $371.54 | $524.81 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $120.23 Typical High $181.97 | Facility | None | $50.12 | $120.23 | $181.97 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $346.74 | Professional | None | $173.78 | $213.80 | $346.74 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | None | $229.09 | $229.09 | $275.42 |
Security Health Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $512.86 | Professional | None | $288.40 | $389.05 | $512.86 |
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 $154.88 Median $380.19 Typical High $630.96 | Professional | None | $154.88 | $380.19 | $630.96 |
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 $72.44 Median $72.44 Typical High $89.13 | Facility | 52 · Reduced service | $72.44 | $72.44 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $36.31 | Facility | 53 · Discontinued | $29.51 | $29.51 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $134.90 | Facility | 54 · Surgery only | $109.65 | $109.65 | $134.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $26.92 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $26.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $17.78 | Facility | 56 · Pre-op care only | $14.79 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $89.13 Typical High $1,071.52 | Professional | 52 · Reduced service | $72.44 | $89.13 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $36.31 Typical High $426.58 | Professional | 53 · Discontinued | $29.51 | $36.31 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $1,621.81 | Professional | 54 · Surgery only | $109.65 | $134.90 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $323.59 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.78 Typical High $213.80 | Professional | 56 · Pre-op care only | $14.79 | $17.78 | $213.80 |
Where Wisconsin sits
The same service costs 2.9 times more in Alaska 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· 2nd of 51
$398
AK $417KY $145
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.