How much rates vary
Facilitymedian $1,862 · 10th to 90th $407 to $4,467Professionalmedian $331 · 10th to 90th $105 to $661
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 $93.33 Median $1,905.46 Typical High $14,454.40 | Facility | None | $93.33 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $1,318.26 | Professional | None | $93.33 | $93.33 | $1,318.26 |
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 $123.03 Median $380.19 Typical High $676.08 | Professional | None | $123.03 | $380.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $630.96 Typical High $1,096.48 | Facility | None | $263.03 | $630.96 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $467.74 | Professional | None | $162.18 | $229.09 | $467.74 |
DeanCare Setting Facility Modifier None Typical Low $109.65 Median $2,818.38 Typical High $5,128.61 | Facility | None | $109.65 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $363.08 | Professional | None | $177.83 | $269.15 | $363.08 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,548.82 Typical High $3,019.95 | Facility | None | $371.54 | $1,548.82 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $323.59 Typical High $741.31 | Professional | None | $114.82 | $323.59 | $741.31 |
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 $147.91 Median $251.19 Typical High $467.74 | Professional | None | $147.91 | $251.19 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $229.09 | Facility | None | $91.20 | $117.49 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $269.15 Typical High $426.58 | Professional | None | $117.49 | $269.15 | $426.58 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $1,174.90 | Facility | None | $537.03 | $758.58 | $1,174.90 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $389.05 | Professional | None | $177.83 | $190.55 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $575.44 Typical High $724.44 | Professional | None | $302.00 | $575.44 | $724.44 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $104.71 Median $281.84 Typical High $562.34 | Professional | None | $104.71 | $281.84 | $562.34 |
5 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 Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $660.69 | Professional | 52 · Reduced service | $46.77 | $46.77 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $263.03 | Professional | 53 · Discontinued | $18.62 | $18.62 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $977.24 | Professional | 54 · Surgery only | $69.18 | $69.18 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $194.98 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $131.83 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $131.83 |
Where Wisconsin sits
The same service costs 4.4 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
$447
AK $479NY $110
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.