How much rates vary
Facilitymedian $1,148 · 10th to 90th $204 to $5,888Professionalmedian $427 · 10th to 90th $174 to $1,175
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 $158.49 Median $3,090.30 Typical High $14,454.40 | Facility | None | $158.49 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $1,548.82 | Professional | None | $158.49 | $158.49 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $7,585.78 | Facility | None | $5,623.41 | $5,888.44 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $630.96 Typical High $1,148.15 | Professional | None | $173.78 | $630.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $1,122.02 | Facility | None | $446.68 | $524.81 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $776.25 | Professional | None | $281.84 | $331.13 | $776.25 |
DeanCare Setting Facility Modifier None Typical Low $199.53 Median $3,162.28 Typical High $5,888.44 | Facility | None | $199.53 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $512.86 | Professional | None | $269.15 | $371.54 | $512.86 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $954.99 Typical High $1,778.28 | Facility | None | $204.17 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $512.86 Typical High $1,318.26 | Professional | None | $190.55 | $512.86 | $1,318.26 |
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 $213.80 Median $407.38 Typical High $524.81 | Professional | None | $213.80 | $407.38 | $524.81 |
Prevea360 Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $812.83 | Facility | None | $162.18 | $204.17 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $794.33 | Professional | None | $173.78 | $363.08 | $794.33 |
Quartz Setting Facility Modifier None Typical Low $575.44 Median $1,000.00 Typical High $2,691.53 | Facility | None | $575.44 | $1,000.00 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | None | $331.13 | $331.13 | $407.38 |
Security Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $1,288.25 | Professional | None | $512.86 | $831.76 | $1,288.25 |
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 $181.97 Median $323.59 Typical High $1,023.29 | Professional | None | $181.97 | $323.59 | $1,023.29 |
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 $79.43 Median $79.43 Typical High $776.25 | Professional | 52 · Reduced service | $79.43 | $79.43 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $309.03 | Professional | 53 · Discontinued | $31.62 | $31.62 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $1,148.15 | Professional | 54 · Surgery only | $120.23 | $120.23 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $234.42 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $154.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $154.88 |
Where Wisconsin sits
The same service costs 4.5 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· 2nd of 51
$513
AK $724NY $162
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.