How much rates vary
Facilitymedian $1,380 · 10th to 90th $72 to $4,074Professionalmedian $195 · 10th to 90th $69 to $447
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 $46.77 Median $72.44 Typical High $14,454.40 | Facility | None | $46.77 | $72.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $645.65 | Professional | None | $46.77 | $72.44 | $645.65 |
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 $81.28 Median $239.88 Typical High $489.78 | Professional | None | $81.28 | $239.88 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $346.74 Typical High $741.31 | Professional | 50 · Both sides | $123.03 | $346.74 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $208.93 Typical High $323.59 | Facility | None | $50.12 | $208.93 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $263.03 | Professional | None | $69.18 | $123.03 | $263.03 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $2,630.27 Typical High $5,128.61 | Facility | None | $56.23 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $263.03 | Professional | None | $109.65 | $165.96 | $263.03 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $912.01 Typical High $1,778.28 | Facility | None | $102.33 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $251.19 Typical High $501.19 | Professional | None | $104.71 | $251.19 | $501.19 |
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 $114.82 Median $199.53 Typical High $316.23 | Professional | None | $114.82 | $199.53 | $316.23 |
Prevea360 Setting Facility Modifier None Typical Low $46.77 Median $83.18 Typical High $154.88 | Facility | None | $46.77 | $83.18 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $281.84 | Professional | None | $87.10 | $169.82 | $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 $69.18 Median $107.15 Typical High $173.78 | Professional | None | $69.18 | $107.15 | $173.78 |
Security Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $213.80 | Professional | None | $138.04 | $138.04 | $213.80 |
Security Health Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $446.68 | Professional | None | $169.82 | $288.40 | $446.68 |
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 $69.18 Median $181.97 Typical High $354.81 | Professional | None | $69.18 | $181.97 | $354.81 |
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 $23.44 Median $23.44 Typical High $36.31 | Facility | 52 · Reduced service | $23.44 | $23.44 | $36.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $14.45 | Facility | 53 · Discontinued | $9.55 | $9.55 | $14.45 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $54.95 | Facility | 54 · Surgery only | $35.48 | $35.48 | $54.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $10.96 | Facility | 55 · Aftercare only | $7.08 | $7.08 | $10.96 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $7.24 | Facility | 56 · Pre-op care only | $4.68 | $4.68 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $36.31 Typical High $380.19 | Professional | 52 · Reduced service | $23.44 | $36.31 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.45 Typical High $154.88 | Professional | 53 · Discontinued | $9.55 | $14.45 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $54.95 Typical High $575.44 | Professional | 54 · Surgery only | $35.48 | $54.95 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.96 Typical High $114.82 | Professional | 55 · Aftercare only | $7.08 | $10.96 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.24 Typical High $77.62 | Professional | 56 · Pre-op care only | $4.68 | $7.24 | $77.62 |
Where Wisconsin sits
The same service costs 3.2 times more in Wisconsin 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· 1st of 51
$229
WI $229KY $72.44
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.