How much rates vary
Facilitymedian $1,202 · 10th to 90th $141 to $3,802Professionalmedian $191 · 10th to 90th $71 to $575
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 $45.71 Median $102.33 Typical High $14,454.40 | Facility | None | $45.71 | $102.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $645.65 | Professional | None | $45.71 | $102.33 | $645.65 |
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 $66.07 Median $186.21 Typical High $389.05 | Professional | None | $66.07 | $186.21 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $275.42 Typical High $588.84 | Professional | 50 · Both sides | $100.00 | $275.42 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $707.95 | Facility | None | $151.36 | $295.12 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $208.93 Typical High $446.68 | Professional | None | $95.50 | $208.93 | $446.68 |
DeanCare Setting Facility Modifier None Typical Low $57.54 Median $2,570.40 Typical High $4,786.30 | Facility | None | $57.54 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $91.20 Median $194.98 Typical High $288.40 | Professional | None | $91.20 | $194.98 | $288.40 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $288.40 Typical High $436.52 | Professional | 50 · Both sides | $138.04 | $288.40 | $436.52 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $812.83 Typical High $1,778.28 | Facility | None | $128.82 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $446.68 Typical High $1,023.29 | Professional | None | $123.03 | $446.68 | $1,023.29 |
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 $100.00 Median $154.88 Typical High $354.81 | Professional | None | $100.00 | $154.88 | $354.81 |
Prevea360 Setting Facility Modifier None Typical Low $45.71 Median $102.33 Typical High $263.03 | Facility | None | $45.71 | $102.33 | $263.03 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $239.88 Typical High $489.78 | Professional | None | $104.71 | $239.88 | $489.78 |
Quartz Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $831.76 | Facility | None | $151.36 | $229.09 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $239.88 | Professional | None | $95.50 | $190.55 | $239.88 |
Security Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $398.11 | Professional | None | $165.96 | $165.96 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $724.44 | Professional | None | $251.19 | $380.19 | $724.44 |
The Alliance Setting Professional Modifier None Typical Low $173.78 Median $436.52 Typical High $676.08 | Professional | None | $173.78 | $436.52 | $676.08 |
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 $67.61 Median $169.82 Typical High $457.09 | Professional | None | $67.61 | $169.82 | $457.09 |
11 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 $22.91 Median $22.91 Typical High $51.29 | Facility | 52 · Reduced service | $22.91 | $22.91 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $20.42 | Facility | 53 · Discontinued | $9.12 | $9.12 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $75.86 | Facility | 54 · Surgery only | $34.67 | $34.67 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $15.49 | Facility | 55 · Aftercare only | $6.92 | $6.92 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $10.23 | Facility | 56 · Pre-op care only | $4.57 | $4.57 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $51.29 Typical High $346.74 | Professional | 52 · Reduced service | $22.91 | $51.29 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $20.42 Typical High $141.25 | Professional | 53 · Discontinued | $9.12 | $20.42 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $75.86 Typical High $524.81 | Professional | 54 · Surgery only | $34.67 | $75.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $15.49 Typical High $104.71 | Professional | 55 · Aftercare only | $6.92 | $15.49 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $10.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $4.57 | $10.23 | $70.79 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $45.71 Median $97.72 Typical High $144.54 | Professional | 51 · Multiple procedures | $45.71 | $97.72 | $144.54 |
Where Wisconsin sits
The same service costs 3.4 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
$209
AK $234KY $69.18
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.