How much rates vary
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 $14,454.40 Median $16,595.87 Typical High $16,595.87 | Facility | None | $14,454.40 | $16,595.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $22,908.68 | Professional | None | $16,595.87 | $16,595.87 | $22,908.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $17,782.79 Typical High $26,302.68 | Facility | None | $12,022.64 | $17,782.79 | $26,302.68 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $21,877.62 Typical High $35,481.34 | Facility | None | $758.58 | $21,877.62 | $35,481.34 |
Medica Setting Facility Modifier None Typical Low $2,041.74 Median $12,882.50 Typical High $27,542.29 | Facility | None | $2,041.74 | $12,882.50 | $27,542.29 |
Network Health Setting Facility Modifier None Typical Low $6,165.95 Median $17,378.01 Typical High $43,651.58 | Facility | None | $6,165.95 | $17,378.01 | $43,651.58 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $21,877.62 Typical High $35,481.34 | Facility | None | $758.58 | $21,877.62 | $35,481.34 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $16,595.87 Typical High $25,118.86 | Facility | None | $2,754.23 | $16,595.87 | $25,118.86 |
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 $8,317.64 Median $8,317.64 Typical High $11,481.54 | Professional | 52 · Reduced service | $8,317.64 | $8,317.64 | $11,481.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,311.31 Median $3,311.31 Typical High $4,570.88 | Professional | 53 · Discontinued | $3,311.31 | $3,311.31 | $4,570.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12,589.25 Median $12,589.25 Typical High $16,982.44 | Professional | 54 · Surgery only | $12,589.25 | $12,589.25 | $16,982.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,511.89 Median $2,511.89 Typical High $3,467.37 | Professional | 55 · Aftercare only | $2,511.89 | $2,511.89 | $3,467.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | 56 · Pre-op care only | $1,659.59 | $1,659.59 | $2,290.87 |
Where Wisconsin sits
The same service costs 371.5 times more in Wyoming than in Montana. 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· 7th of 51
$16,982
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.