How much rates vary
Facilitymedian $1,445 · 10th to 90th $63 to $4,074Professionalmedian $44 · 10th to 90th $14 to $91
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 $14.45 Median $25.12 Typical High $14,454.40 | Facility | None | $14.45 | $25.12 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $158.49 | Professional | None | $14.45 | $14.45 | $158.49 |
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 $19.05 Median $48.98 Typical High $91.20 | Professional | None | $19.05 | $48.98 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $28.18 Median $74.13 Typical High $138.04 | Professional | 50 · Both sides | $28.18 | $74.13 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $50.12 Typical High $1,071.52 | Facility | None | $42.66 | $50.12 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $30.90 Typical High $57.54 | Professional | None | $21.38 | $30.90 | $57.54 |
DeanCare Setting Facility Modifier None Typical Low $17.38 Median $2,818.38 Typical High $5,370.32 | Facility | None | $17.38 | $2,818.38 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $28.18 Median $41.69 Typical High $45.71 | Professional | None | $28.18 | $41.69 | $45.71 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $812.83 Typical High $1,778.28 | Facility | None | $72.44 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $14.45 Median $36.31 Typical High $74.13 | Professional | None | $14.45 | $36.31 | $74.13 |
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 $22.91 Median $39.81 Typical High $45.71 | Professional | None | $22.91 | $39.81 | $45.71 |
Prevea360 Setting Facility Modifier None Typical Low $14.45 Median $17.38 Typical High $33.11 | Facility | None | $14.45 | $17.38 | $33.11 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $40.74 Typical High $69.18 | Professional | None | $19.05 | $40.74 | $69.18 |
Quartz Setting Facility Modifier None Typical Low $66.07 Median $812.83 Typical High $1,479.11 | Facility | None | $66.07 | $812.83 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $45.71 | Professional | None | $21.38 | $21.38 | $45.71 |
Security Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Security Health Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $91.20 | Professional | None | $41.69 | $64.57 | $91.20 |
The Alliance Setting Professional Modifier None Typical Low $31.62 Median $81.28 Typical High $114.82 | Professional | None | $31.62 | $81.28 | $114.82 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,148.15 Typical High $1,862.09 | Facility | None | $204.17 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $15.49 Median $38.02 Typical High $75.86 | Professional | None | $15.49 | $38.02 | $75.86 |
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 $7.24 Median $7.24 Typical High $87.10 | Professional | 52 · Reduced service | $7.24 | $7.24 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $34.67 | Professional | 53 · Discontinued | $2.88 | $2.88 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $10.96 Typical High $128.82 | Professional | 54 · Surgery only | $10.96 | $10.96 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $25.70 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $17.38 |
Where Wisconsin sits
The same service costs 7.4 times more in Kansas 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· 3rd of 51
$57.54
KS $95.50KY $12.88
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.