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 $38.02 Median $6,456.54 Typical High $14,454.40 | Facility | None | $38.02 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $3,090.30 | Professional | None | $38.02 | $38.02 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $28,183.83 | Facility | None | $12,022.64 | $16,982.44 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $47.86 | Professional | None | $14.45 | $14.45 | $47.86 |
DeanCare Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $14,791.08 | Facility | None | $6,165.95 | $8,128.31 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $19,054.61 | Facility | None | $436.52 | $2,818.38 | $19,054.61 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
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 $19.05 Median $19.05 Typical High $1,548.82 | Professional | 52 · Reduced service | $19.05 | $19.05 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $616.60 | Professional | 53 · Discontinued | $7.59 | $7.59 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $2,344.23 | Professional | 54 · Surgery only | $28.84 | $28.84 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $467.74 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $309.03 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $309.03 |
Where Wisconsin sits
The same service costs 295.1 times more in Alaska 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· 2nd of 51
$4,074
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.