How much rates vary
Facilitymedian $1,000 · 10th to 90th $47 to $2,344Professionalmedian $105 · 10th to 90th $44 to $234
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 $28.18 Median $44.67 Typical High $14,454.40 | Facility | None | $28.18 | $44.67 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $194.98 | Professional | None | $28.18 | $44.67 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $134.90 Typical High $302.00 | Professional | None | $46.77 | $134.90 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $154.88 Typical High $1,479.11 | Facility | None | $138.04 | $154.88 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $93.33 Typical High $173.78 | Professional | None | $46.77 | $93.33 | $173.78 |
DeanCare Setting Facility Modifier None Typical Low $35.48 Median $2,630.27 Typical High $5,128.61 | Facility | None | $35.48 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $38.90 Median $79.43 Typical High $138.04 | Professional | None | $38.90 | $79.43 | $138.04 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $912.01 Typical High $1,778.28 | Facility | None | $60.26 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $208.93 | Professional | None | $54.95 | $114.82 | $208.93 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $44.67 Median $97.72 Typical High $158.49 | Professional | None | $44.67 | $97.72 | $158.49 |
Prevea360 Setting Facility Modifier None Typical Low $29.51 Median $46.77 Typical High $64.57 | Facility | None | $29.51 | $46.77 | $64.57 |
Prevea360 Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Quartz Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $177.83 | Professional | None | $53.70 | $114.82 | $177.83 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $138.04 | Professional | None | $46.77 | $46.77 | $138.04 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $61.66 | Professional | None | $38.90 | $38.90 | $61.66 |
Security Health Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $181.97 | Professional | None | $52.48 | $89.13 | $181.97 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $41.69 Median $93.33 Typical High $186.21 | Professional | None | $41.69 | $93.33 | $186.21 |
10 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 $14.13 Median $14.13 Typical High $22.39 | Facility | 52 · Reduced service | $14.13 | $14.13 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $9.12 | Facility | 53 · Discontinued | $5.62 | $5.62 | $9.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $20.89 Median $20.89 Typical High $33.88 | Facility | 54 · Surgery only | $20.89 | $20.89 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $6.76 | Facility | 55 · Aftercare only | $4.17 | $4.17 | $6.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $4.47 | Facility | 56 · Pre-op care only | $2.82 | $2.82 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $22.39 Typical High $125.89 | Professional | 52 · Reduced service | $14.13 | $22.39 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $9.12 Typical High $50.12 | Professional | 53 · Discontinued | $5.62 | $9.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $33.88 Typical High $186.21 | Professional | 54 · Surgery only | $20.89 | $33.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $6.76 Typical High $37.15 | Professional | 55 · Aftercare only | $4.17 | $6.76 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.47 Typical High $25.12 | Professional | 56 · Pre-op care only | $2.82 | $4.47 | $25.12 |
Where Wisconsin sits
The same service costs 2.8 times more in Alaska than in California. 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
$115
AK $129CA $46.77
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.