How much rates vary
Facilitymedian $1,000 · 10th to 90th $110 to $2,188Professionalmedian $224 · 10th to 90th $105 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 $70.79 Median $109.65 Typical High $14,454.40 | Facility | None | $70.79 | $109.65 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $831.76 | Professional | None | $70.79 | $109.65 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $295.12 Typical High $524.81 | Professional | None | $104.71 | $295.12 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $363.08 Typical High $1,479.11 | Facility | None | $309.03 | $363.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $467.74 | Professional | None | $141.25 | $223.87 | $467.74 |
DeanCare Setting Facility Modifier None Typical Low $91.20 Median $2,630.27 Typical High $5,128.61 | Facility | None | $91.20 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $309.03 | Professional | None | $141.25 | $208.93 | $309.03 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $1,778.28 | Facility | None | $128.82 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $407.38 Typical High $891.25 | Professional | None | $128.82 | $407.38 | $891.25 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $478.63 | Professional | None | $144.54 | $229.09 | $478.63 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $229.09 | Facility | None | $72.44 | $112.20 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $501.19 | Professional | None | $138.04 | $269.15 | $501.19 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $2,691.53 | Facility | None | $645.65 | $1,071.52 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $269.15 | Professional | None | $147.91 | $213.80 | $269.15 |
Security Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | None | $275.42 | $275.42 | $416.87 |
Security Health Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $831.76 | Professional | None | $436.52 | $575.44 | $831.76 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $524.81 | Professional | None | $102.33 | $177.83 | $524.81 |
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 $35.48 Median $35.48 Typical High $54.95 | Facility | 52 · Reduced service | $35.48 | $35.48 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $21.88 | Facility | 53 · Discontinued | $14.45 | $14.45 | $21.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $81.28 | Facility | 54 · Surgery only | $53.70 | $53.70 | $81.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $16.22 | Facility | 55 · Aftercare only | $10.72 | $10.72 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.96 | Facility | 56 · Pre-op care only | $7.08 | $7.08 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $54.95 Typical High $416.87 | Professional | 52 · Reduced service | $35.48 | $54.95 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $21.88 Typical High $165.96 | Professional | 53 · Discontinued | $14.45 | $21.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $81.28 Typical High $630.96 | Professional | 54 · Surgery only | $53.70 | $81.28 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.22 Typical High $125.89 | Professional | 55 · Aftercare only | $10.72 | $16.22 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.96 Typical High $83.18 | Professional | 56 · Pre-op care only | $7.08 | $10.96 | $83.18 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$240
AK $331FL $93.33
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.