How much rates vary
Facilitymedian $2,399 · 10th to 90th $195 to $5,129Professionalmedian $347 · 10th to 90th $141 to $832
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 $97.72 Median $194.98 Typical High $14,454.40 | Facility | None | $97.72 | $194.98 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $1,023.29 | Professional | None | $97.72 | $194.98 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $5,754.40 | Facility | None | $1,380.38 | $2,951.21 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $831.76 | Professional | None | $204.17 | $389.05 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $588.84 Typical High $870.96 | Facility | None | $512.86 | $588.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $251.19 Typical High $691.83 | Professional | None | $107.15 | $251.19 | $691.83 |
DeanCare Setting Facility Modifier None Typical Low $125.89 Median $2,630.27 Typical High $5,128.61 | Facility | None | $125.89 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $478.63 | Professional | None | $165.96 | $281.84 | $478.63 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $208.93 Typical High $1,023.29 | Facility | None | $104.71 | $208.93 | $1,023.29 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $645.65 Typical High $1,479.11 | Professional | None | $257.04 | $645.65 | $1,479.11 |
Network Health Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $245.47 | Facility | None | $173.78 | $173.78 | $245.47 |
Network Health Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $602.56 | Professional | None | $234.42 | $338.84 | $602.56 |
Prevea360 Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $398.11 | Facility | None | $104.71 | $194.98 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $707.95 | Professional | None | $169.82 | $371.54 | $707.95 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $389.05 | Professional | None | $107.15 | $218.78 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $288.40 | Professional | None | $141.25 | $141.25 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $812.83 | Professional | None | $208.93 | $407.38 | $812.83 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
United Setting Professional Modifier None Typical Low $141.25 Median $363.08 Typical High $851.14 | Professional | None | $141.25 | $363.08 | $851.14 |
11 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 $97.72 | Facility | 52 · Reduced service | $48.98 | $48.98 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $38.90 | Facility | 53 · Discontinued | $19.50 | $19.50 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $147.91 | Facility | 54 · Surgery only | $72.44 | $72.44 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $29.51 | Facility | 55 · Aftercare only | $14.45 | $14.45 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $19.50 | Facility | 56 · Pre-op care only | $9.77 | $9.77 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $97.72 Typical High $537.03 | Professional | 52 · Reduced service | $48.98 | $97.72 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $213.80 | Professional | 53 · Discontinued | $19.50 | $38.90 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $147.91 Typical High $794.33 | Professional | 54 · Surgery only | $72.44 | $147.91 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $29.51 Typical High $158.49 | Professional | 55 · Aftercare only | $14.45 | $29.51 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $9.77 | $19.50 | $107.15 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $141.25 Typical High $239.88 | Professional | 51 · Multiple procedures | $83.18 | $141.25 | $239.88 |
Where Wisconsin sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$380
AK $468MD $138
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.