How much rates vary
Facilitymedian $1,380 · 10th to 90th $74 to $3,981Professionalmedian $158 · 10th to 90th $65 to $347
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 $43.65 Median $74.13 Typical High $14,454.40 | Facility | None | $43.65 | $74.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $616.60 | Professional | None | $43.65 | $74.13 | $616.60 |
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 $69.18 Median $177.83 Typical High $295.12 | Professional | None | $69.18 | $177.83 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $269.15 Typical High $446.68 | Professional | 50 · Both sides | $102.33 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $213.80 Typical High $331.13 | Facility | None | $50.12 | $213.80 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $120.23 Typical High $269.15 | Professional | None | $64.57 | $120.23 | $269.15 |
DeanCare Setting Facility Modifier None Typical Low $51.29 Median $2,630.27 Typical High $5,128.61 | Facility | None | $51.29 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $263.03 | Professional | None | $100.00 | $154.88 | $263.03 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $812.83 Typical High $1,778.28 | Facility | None | $93.33 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $257.04 Typical High $524.81 | Professional | None | $102.33 | $257.04 | $524.81 |
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 $117.49 Median $204.17 Typical High $288.40 | Professional | None | $117.49 | $204.17 | $288.40 |
Prevea360 Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $158.49 | Facility | None | $43.65 | $75.86 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $281.84 | Professional | None | $89.13 | $162.18 | $281.84 |
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 $64.57 Median $109.65 Typical High $154.88 | Professional | None | $64.57 | $109.65 | $154.88 |
Security Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | None | $128.82 | $128.82 | $223.87 |
Security Health Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $457.09 | Professional | None | $158.49 | $263.03 | $457.09 |
The Alliance Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | None | $194.98 | $199.53 | $199.53 |
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 $66.07 Median $165.96 Typical High $363.08 | Professional | None | $66.07 | $165.96 | $363.08 |
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 $21.88 Median $21.88 Typical High $37.15 | Facility | 52 · Reduced service | $21.88 | $21.88 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $14.79 | Facility | 53 · Discontinued | $8.71 | $8.71 | $14.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $56.23 | Facility | 54 · Surgery only | $33.11 | $33.11 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $11.22 | Facility | 55 · Aftercare only | $6.61 | $6.61 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $7.41 | Facility | 56 · Pre-op care only | $4.37 | $4.37 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $37.15 Typical High $331.13 | Professional | 52 · Reduced service | $21.88 | $37.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $14.79 Typical High $131.83 | Professional | 53 · Discontinued | $8.71 | $14.79 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $56.23 Typical High $489.78 | Professional | 54 · Surgery only | $33.11 | $56.23 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.22 Typical High $97.72 | Professional | 55 · Aftercare only | $6.61 | $11.22 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.41 Typical High $66.07 | Professional | 56 · Pre-op care only | $4.37 | $7.41 | $66.07 |
Where Wisconsin sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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
$195
AK $214KY $64.57
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.