How much rates vary
Facilitymedian $107 · 10th to 90th $89 to $295Professionalmedian $186 · 10th to 90th $59 to $589
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 $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $1,023.29 | Professional | None | $100.00 | $107.15 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $316.23 Typical High $630.96 | Professional | None | $102.33 | $316.23 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $389.05 | Facility | None | $173.78 | $257.04 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $251.19 | Professional | None | $40.74 | $79.43 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $169.82 | Facility | None | $70.79 | $100.00 | $169.82 |
DeanCare Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | None | $239.88 | $257.04 | $288.40 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $436.52 | Facility | None | $70.79 | $104.71 | $436.52 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $363.08 Typical High $588.84 | Professional | None | $91.20 | $363.08 | $588.84 |
Network Health Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $190.55 | Facility | None | $169.82 | $190.55 | $190.55 |
Network Health Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $151.36 | Professional | None | $89.13 | $134.90 | $151.36 |
Prevea360 Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $169.82 | Facility | None | $70.79 | $100.00 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $269.15 | Professional | None | $104.71 | $199.53 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $151.36 | Professional | None | $40.74 | $47.86 | $151.36 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | None | $186.21 | $186.21 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $645.65 | Professional | None | $457.09 | $524.81 | $645.65 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $346.74 | Professional | None | $63.10 | $95.50 | $346.74 |
8 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 $48.98 Median $48.98 Typical High $53.70 | Facility | 52 · Reduced service | $48.98 | $48.98 | $53.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $21.38 | Facility | 53 · Discontinued | $19.95 | $19.95 | $21.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $16.22 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $16.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.72 | Facility | 56 · Pre-op care only | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $53.70 Typical High $512.86 | Professional | 52 · Reduced service | $48.98 | $53.70 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $204.17 | Professional | 53 · Discontinued | $19.95 | $21.38 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $154.88 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $102.33 | Professional | 56 · Pre-op care only | $10.00 | $10.72 | $102.33 |
Where Wisconsin sits
The same service costs 5.0 times more in Alaska than in Alabama. 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
$174
AK $269AL $53.70
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.