How much rates vary
Facilitymedian $1,585 · 10th to 90th $89 to $4,365Professionalmedian $141 · 10th to 90th $60 to $417
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 $38.02 Median $69.18 Typical High $14,454.40 | Facility | None | $38.02 | $69.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $562.34 | Professional | None | $38.02 | $69.18 | $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 $54.95 Median $158.49 Typical High $281.84 | Professional | None | $54.95 | $158.49 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $234.42 Typical High $416.87 | Professional | 50 · Both sides | $83.18 | $234.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $199.53 Typical High $707.95 | Facility | None | $91.20 | $199.53 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $302.00 | Professional | None | $79.43 | $141.25 | $302.00 |
DeanCare Setting Facility Modifier None Typical Low $48.98 Median $2,630.27 Typical High $5,128.61 | Facility | None | $48.98 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $186.21 | Professional | None | $72.44 | $114.82 | $186.21 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $173.78 Typical High $281.84 | Professional | 50 · Both sides | $107.15 | $173.78 | $281.84 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $1,412.54 Typical High $3,019.95 | Facility | None | $154.88 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $316.23 Typical High $1,348.96 | Professional | None | $95.50 | $316.23 | $1,348.96 |
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 $67.61 Median $154.88 Typical High $275.42 | Professional | None | $67.61 | $154.88 | $275.42 |
Prevea360 Setting Facility Modifier None Typical Low $38.90 Median $70.79 Typical High $147.91 | Facility | None | $38.90 | $70.79 | $147.91 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $177.83 Typical High $323.59 | Professional | None | $85.11 | $177.83 | $323.59 |
Quartz Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $831.76 | Facility | None | $89.13 | $134.90 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $169.82 | Professional | None | $79.43 | $138.04 | $169.82 |
Security Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $269.15 | Professional | None | $147.91 | $147.91 | $269.15 |
Security Health Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $501.19 | Professional | None | $162.18 | $288.40 | $501.19 |
The Alliance Setting Professional Modifier None Typical Low $114.82 Median $281.84 Typical High $501.19 | Professional | None | $114.82 | $281.84 | $501.19 |
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 $58.88 Median $125.89 Typical High $323.59 | Professional | None | $58.88 | $125.89 | $323.59 |
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 $19.05 Median $19.05 Typical High $34.67 | Facility | 52 · Reduced service | $19.05 | $19.05 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $13.80 | Facility | 53 · Discontinued | $7.76 | $7.76 | $13.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $51.29 | Facility | 54 · Surgery only | $28.84 | $28.84 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $10.23 | Facility | 55 · Aftercare only | $5.75 | $5.75 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $6.92 | Facility | 56 · Pre-op care only | $3.80 | $3.80 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $34.67 Typical High $489.78 | Professional | 52 · Reduced service | $19.05 | $34.67 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $194.98 | Professional | 53 · Discontinued | $7.76 | $13.80 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $51.29 Typical High $724.44 | Professional | 54 · Surgery only | $28.84 | $51.29 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.23 Typical High $144.54 | Professional | 55 · Aftercare only | $5.75 | $10.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.92 Typical High $97.72 | Professional | 56 · Pre-op care only | $3.80 | $6.92 | $97.72 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $36.31 Median $57.54 Typical High $93.33 | Professional | 51 · Multiple procedures | $36.31 | $57.54 | $93.33 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Virginia. 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
$155
AK $204VA $58.88
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.