How much rates vary
Facilitymedian $1,259 · 10th to 90th $32 to $3,802Professionalmedian $62 · 10th to 90th $30 to $182
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 $22.39 Median $29.51 Typical High $14,454.40 | Facility | None | $22.39 | $29.51 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $398.11 | Professional | None | $22.39 | $29.51 | $398.11 |
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 $32.36 Median $93.33 Typical High $162.18 | Professional | None | $32.36 | $93.33 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $85.11 Typical High $1,000.00 | Facility | None | $26.92 | $85.11 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $125.89 | Professional | None | $46.77 | $61.66 | $125.89 |
DeanCare Setting Facility Modifier None Typical Low $28.18 Median $3,162.28 Typical High $5,888.44 | Facility | None | $28.18 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $83.18 | Professional | None | $44.67 | $63.10 | $83.18 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $912.01 Typical High $1,778.28 | Facility | None | $54.95 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $134.90 Typical High $831.76 | Professional | None | $41.69 | $134.90 | $831.76 |
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 $29.51 Median $56.23 Typical High $104.71 | Professional | None | $29.51 | $56.23 | $104.71 |
Prevea360 Setting Facility Modifier None Typical Low $22.39 Median $35.48 Typical High $64.57 | Facility | None | $22.39 | $35.48 | $64.57 |
Quartz Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $138.04 | Professional | None | $37.15 | $72.44 | $138.04 |
Quartz Setting Facility Modifier None Typical Low $26.30 Median $40.74 Typical High $1,122.02 | Facility | None | $26.30 | $40.74 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $74.13 | Professional | None | $46.77 | $61.66 | $74.13 |
Security Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | None | $29.51 | $29.51 | $37.15 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $141.25 | Professional | None | $38.90 | $69.18 | $141.25 |
The Alliance Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $29.51 Median $58.88 Typical High $154.88 | Professional | None | $29.51 | $58.88 | $154.88 |
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 $11.22 Median $11.22 Typical High $14.79 | Facility | 52 · Reduced service | $11.22 | $11.22 | $14.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $5.89 | Facility | 53 · Discontinued | $4.47 | $4.47 | $5.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $16.98 Median $16.98 Typical High $22.39 | Facility | 54 · Surgery only | $16.98 | $16.98 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $4.47 | Facility | 55 · Aftercare only | $3.39 | $3.39 | $4.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.95 | Facility | 56 · Pre-op care only | $2.24 | $2.24 | $2.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $14.79 Typical High $199.53 | Professional | 52 · Reduced service | $11.22 | $14.79 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.89 Typical High $79.43 | Professional | 53 · Discontinued | $4.47 | $5.89 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $22.39 Typical High $295.12 | Professional | 54 · Surgery only | $16.98 | $22.39 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.47 Typical High $58.88 | Professional | 55 · Aftercare only | $3.39 | $4.47 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.95 Typical High $39.81 | Professional | 56 · Pre-op care only | $2.24 | $2.95 | $39.81 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$75.86
AK $100MD $28.84
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.