How much rates vary
Facilitymedian $1,380 · 10th to 90th $50 to $4,074Professionalmedian $62 · 10th to 90th $26 to $302
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 $26.30 Median $30.90 Typical High $14,454.40 | Facility | None | $26.30 | $30.90 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $331.13 | Professional | None | $26.30 | $30.90 | $331.13 |
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 $30.90 Median $87.10 Typical High $316.23 | Professional | None | $30.90 | $87.10 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $46.77 Median $131.83 Typical High $467.74 | Professional | 50 · Both sides | $46.77 | $131.83 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $56.23 Typical High $77.62 | Facility | None | $50.12 | $56.23 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $43.65 Typical High $97.72 | Professional | None | $16.22 | $43.65 | $97.72 |
DeanCare Setting Facility Modifier None Typical Low $22.39 Median $2,630.27 Typical High $5,128.61 | Facility | None | $22.39 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $66.07 | Professional | None | $34.67 | $50.12 | $66.07 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $912.01 Typical High $1,778.28 | Facility | None | $54.95 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $112.20 Typical High $645.65 | Professional | None | $40.74 | $112.20 | $645.65 |
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 $70.79 Median $120.23 Typical High $186.21 | Professional | None | $70.79 | $120.23 | $186.21 |
Prevea360 Setting Facility Modifier None Typical Low $20.42 Median $28.84 Typical High $66.07 | Facility | None | $20.42 | $28.84 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $20.89 Median $44.67 Typical High $125.89 | Professional | None | $20.89 | $44.67 | $125.89 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $13.80 Median $37.15 Typical High $48.98 | Professional | None | $13.80 | $37.15 | $48.98 |
Security Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | None | $91.20 | $91.20 | $104.71 |
Security Health Setting Professional Modifier None Typical Low $56.23 Median $181.97 Typical High $269.15 | Professional | None | $56.23 | $181.97 | $269.15 |
The Alliance Setting Professional Modifier None Typical Low $33.11 Median $69.18 Typical High $165.96 | Professional | None | $33.11 | $69.18 | $165.96 |
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 $28.18 Median $74.13 Typical High $169.82 | Professional | None | $28.18 | $74.13 | $169.82 |
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 $12.88 Median $12.88 Typical High $15.49 | Facility | 52 · Reduced service | $12.88 | $12.88 | $15.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $6.17 | Facility | 53 · Discontinued | $5.25 | $5.25 | $6.17 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $22.91 | Facility | 54 · Surgery only | $19.50 | $19.50 | $22.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.57 | Facility | 55 · Aftercare only | $3.89 | $3.89 | $4.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.09 | Facility | 56 · Pre-op care only | $2.63 | $2.63 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $15.49 Typical High $169.82 | Professional | 52 · Reduced service | $12.88 | $15.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.17 Typical High $67.61 | Professional | 53 · Discontinued | $5.25 | $6.17 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $22.91 Typical High $251.19 | Professional | 54 · Surgery only | $19.50 | $22.91 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.57 Typical High $50.12 | Professional | 55 · Aftercare only | $3.89 | $4.57 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.09 Typical High $33.88 | Professional | 56 · Pre-op care only | $2.63 | $3.09 | $33.88 |
Where Wisconsin sits
The same service costs 4.3 times more in Wyoming 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· 3rd of 51
$87.10
WY $89.13NY $20.89
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.