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 $8,317.64 Median $14,454.40 Typical High $18,197.01 | Facility | None | $8,317.64 | $14,454.40 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $28,840.32 | Professional | None | $18,197.01 | $18,197.01 | $28,840.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $18,620.87 Typical High $25,703.96 | Facility | None | $13,182.57 | $18,620.87 | $25,703.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $23,442.29 Typical High $38,904.51 | Facility | None | $758.58 | $23,442.29 | $38,904.51 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $9,549.93 Typical High $19,952.62 | Facility | None | $1,445.44 | $9,549.93 | $19,952.62 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $23,442.29 Typical High $38,904.51 | Facility | None | $758.58 | $23,442.29 | $38,904.51 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
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 $8,912.51 Median $8,912.51 Typical High $14,454.40 | Professional | 52 · Reduced service | $8,912.51 | $8,912.51 | $14,454.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,630.78 Median $3,630.78 Typical High $5,754.40 | Professional | 53 · Discontinued | $3,630.78 | $3,630.78 | $5,754.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13,489.63 Median $13,489.63 Typical High $21,877.62 | Professional | 54 · Surgery only | $13,489.63 | $13,489.63 | $21,877.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,691.53 Median $2,691.53 Typical High $4,365.16 | Professional | 55 · Aftercare only | $2,691.53 | $2,691.53 | $4,365.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,819.70 Median $1,819.70 Typical High $2,884.03 | Professional | 56 · Pre-op care only | $1,819.70 | $1,819.70 | $2,884.03 |
Where Wisconsin sits
The same service costs 323.6 times more in Alaska 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
$17,783
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.