How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $141.25 Median $141.25 Typical High $14,454.40 | Facility | None | $141.25 | $141.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $707.95 | Professional | None | $141.25 | $141.25 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $1,096.48 | Professional | None | $162.18 | $389.05 | $1,096.48 |
DeanCare Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $363.08 | Facility | None | $141.25 | $194.98 | $363.08 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $181.97 | Professional | None | $120.23 | $181.97 | $181.97 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $363.08 Typical High $5,011.87 | Facility | None | $169.82 | $363.08 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $1,122.02 Typical High $1,122.02 | Professional | None | $269.15 | $1,122.02 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $363.08 | Facility | None | $141.25 | $194.98 | $363.08 |
Prevea360 Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $416.87 Typical High $575.44 | Professional | None | $204.17 | $416.87 | $575.44 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Security Health Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $363.08 | Professional | None | $281.84 | $323.59 | $363.08 |
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 $70.79 Median $70.79 Typical High $354.81 | Professional | 52 · Reduced service | $70.79 | $70.79 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $144.54 | Professional | 53 · Discontinued | $28.18 | $28.18 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $537.03 | Professional | 54 · Surgery only | $104.71 | $104.71 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $107.15 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $70.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $70.79 |
Where Wisconsin sits
The same service costs 7.6 times more in Nebraska than in West Virginia. 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· 11th of 51
$372
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.