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 $1,258.93 Median $1,258.93 Typical High $2,818.38 | Facility | None | $1,258.93 | $1,258.93 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,258.93 | $3,090.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,174.90 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,737.80 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,288.25 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,202.26 | $1,445.44 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,630.27 | Facility | None | $1,445.44 | $1,698.24 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,202.26 | $1,659.59 |
Network Health Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Prevea360 Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,202.26 | $1,445.44 | $1,445.44 |
Quartz Setting Facility Modifier None Typical Low $1,737.80 Median $3,981.07 Typical High $3,981.07 | Facility | None | $1,737.80 | $3,981.07 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,230.27 | Professional | None | $660.69 | $660.69 | $1,230.27 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
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 $630.96 Median $630.96 Typical High $1,548.82 | Professional | 52 · Reduced service | $630.96 | $630.96 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $616.60 | Professional | 53 · Discontinued | $257.04 | $257.04 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $2,290.87 | Professional | 54 · Surgery only | $954.99 | $954.99 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $467.74 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $309.03 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $309.03 |
Where Wisconsin sits
The same service costs 2.9 times more in Minnesota than in Alabama. 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· 20th of 51
$1,288
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.