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 $6,456.54 Median $14,454.40 Typical High $19,054.61 | Facility | None | $6,456.54 | $14,454.40 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $30,902.95 | Professional | None | $19,054.61 | $19,054.61 | $30,902.95 |
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 $10,715.19 Typical High $17,782.79 | Facility | None | $758.58 | $10,715.19 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $13,489.63 | Professional | None | $120.23 | $120.23 | $13,489.63 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $9,120.11 Typical High $19,498.45 | Facility | None | $1,412.54 | $9,120.11 | $19,498.45 |
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 $10,715.19 Typical High $17,782.79 | Facility | None | $758.58 | $10,715.19 | $17,782.79 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $9,549.93 Median $9,549.93 Typical High $15,488.17 | Professional | 52 · Reduced service | $9,549.93 | $9,549.93 | $15,488.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,801.89 Median $3,801.89 Typical High $6,165.95 | Professional | 53 · Discontinued | $3,801.89 | $3,801.89 | $6,165.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14,125.38 Median $14,125.38 Typical High $22,908.68 | Professional | 54 · Surgery only | $14,125.38 | $14,125.38 | $22,908.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,818.38 Median $2,818.38 Typical High $4,570.88 | Professional | 55 · Aftercare only | $2,818.38 | $2,818.38 | $4,570.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,905.46 Median $1,905.46 Typical High $3,090.30 | Professional | 56 · Pre-op care only | $1,905.46 | $1,905.46 | $3,090.30 |
Where Wisconsin sits
The same service costs 239.9 times more in Minnesota 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· 2nd of 51
$15,136
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.