How much rates vary
Facilitymedian $1,202 · 10th to 90th $83 to $3,802Professionalmedian $174 · 10th to 90th $74 to $537
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 $89.13 Median $107.15 Typical High $14,454.40 | Facility | None | $89.13 | $107.15 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $794.33 | Professional | None | $89.13 | $107.15 | $794.33 |
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 $72.44 Median $245.47 Typical High $524.81 | Professional | None | $72.44 | $245.47 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $363.08 Typical High $794.33 | Professional | 50 · Both sides | $107.15 | $363.08 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $95.50 Typical High $239.88 | Facility | None | $50.12 | $95.50 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $338.84 | Professional | None | $56.23 | $151.36 | $338.84 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $2,630.27 Typical High $5,128.61 | Facility | None | $70.79 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $229.09 | Professional | None | $117.49 | $173.78 | $229.09 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $912.01 Typical High $1,778.28 | Facility | None | $114.82 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $263.03 Typical High $575.44 | Professional | None | $85.11 | $263.03 | $575.44 |
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 $169.82 Median $186.21 Typical High $281.84 | Professional | None | $169.82 | $186.21 | $281.84 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $85.11 Typical High $141.25 | Facility | None | $64.57 | $85.11 | $141.25 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $338.84 | Professional | None | $87.10 | $165.96 | $338.84 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $69.18 Typical High $104.71 | Facility | None | $50.12 | $69.18 | $104.71 |
Quartz Setting Professional Modifier None Typical Low $47.86 Median $125.89 Typical High $151.36 | Professional | None | $47.86 | $125.89 | $151.36 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | None | $295.12 | $295.12 | $354.81 |
Security Health Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $758.58 | Professional | None | $213.80 | $478.63 | $758.58 |
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 $74.13 Median $151.36 Typical High $331.13 | Professional | None | $74.13 | $151.36 | $331.13 |
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 $44.67 Median $44.67 Typical High $53.70 | Facility | 52 · Reduced service | $44.67 | $44.67 | $53.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $21.38 | Facility | 53 · Discontinued | $17.78 | $17.78 | $21.38 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $79.43 | Facility | 54 · Surgery only | $66.07 | $66.07 | $79.43 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $15.85 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.72 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $53.70 Typical High $398.11 | Professional | 52 · Reduced service | $44.67 | $53.70 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.38 Typical High $158.49 | Professional | 53 · Discontinued | $17.78 | $21.38 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $79.43 Typical High $588.84 | Professional | 54 · Surgery only | $66.07 | $79.43 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.85 Typical High $117.49 | Professional | 55 · Aftercare only | $13.49 | $15.85 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.72 Typical High $79.43 | Professional | 56 · Pre-op care only | $8.91 | $10.72 | $79.43 |
Where Wisconsin sits
The same service costs 3.8 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
$224
AK $257FL $67.61
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.