How much rates vary
Facilitymedian $3,020 · 10th to 90th $251 to $7,762Professionalmedian $490 · 10th to 90th $182 to $1,122
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 $114.82 Median $208.93 Typical High $14,454.40 | Facility | None | $114.82 | $208.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $3,715.35 | Professional | None | $114.82 | $208.93 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,818.38 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $602.56 Typical High $1,122.02 | Professional | None | $218.78 | $602.56 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $870.96 Typical High $1,698.24 | Professional | 50 · Both sides | $295.12 | $870.96 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $602.56 Typical High $1,445.44 | Facility | None | $245.47 | $602.56 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $776.25 | Professional | None | $169.82 | $331.13 | $776.25 |
DeanCare Setting Facility Modifier None Typical Low $144.54 Median $5,248.07 Typical High $9,549.93 | Facility | None | $144.54 | $5,248.07 | $9,549.93 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $630.96 | Professional | None | $263.03 | $407.38 | $630.96 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $2,187.76 Typical High $4,786.30 | Facility | None | $398.11 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $707.95 Typical High $5,754.40 | Professional | None | $245.47 | $707.95 | $5,754.40 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $691.83 | Professional | None | $331.13 | $478.63 | $691.83 |
Prevea360 Setting Facility Modifier None Typical Low $114.82 Median $245.47 Typical High $933.25 | Facility | None | $114.82 | $245.47 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $741.31 | Professional | None | $234.42 | $426.58 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $239.88 Median $371.54 Typical High $1,698.24 | Facility | None | $239.88 | $371.54 | $1,698.24 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $501.19 | Professional | None | $169.82 | $309.03 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $645.65 | Professional | None | $338.84 | $338.84 | $645.65 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,288.25 | Professional | None | $478.63 | $691.83 | $1,288.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $177.83 Median $436.52 Typical High $954.99 | Professional | None | $177.83 | $436.52 | $954.99 |
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 $57.54 Median $57.54 Typical High $104.71 | Facility | 52 · Reduced service | $57.54 | $57.54 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $41.69 | Facility | 53 · Discontinued | $22.91 | $22.91 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $158.49 | Facility | 54 · Surgery only | $85.11 | $85.11 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $31.62 | Facility | 55 · Aftercare only | $16.98 | $16.98 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $20.89 | Facility | 56 · Pre-op care only | $11.48 | $11.48 | $20.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $104.71 Typical High $2,398.83 | Professional | 52 · Reduced service | $57.54 | $104.71 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $41.69 Typical High $954.99 | Professional | 53 · Discontinued | $22.91 | $41.69 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $158.49 Typical High $3,630.78 | Professional | 54 · Surgery only | $85.11 | $158.49 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $31.62 Typical High $724.44 | Professional | 55 · Aftercare only | $16.98 | $31.62 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.89 Typical High $478.63 | Professional | 56 · Pre-op care only | $11.48 | $20.89 | $478.63 |
Where Wisconsin sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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
$603
OK $692TX $214
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.