How much rates vary
Facilitymedian $257 · 10th to 90th $182 to $490Professionalmedian $182 · 10th to 90th $123 to $724
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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $457.09 | Professional | None | $190.55 | $190.55 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $1,023.29 | Professional | None | $100.00 | $234.42 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $501.19 | Facility | None | $199.53 | $354.81 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $234.42 | Professional | None | $125.89 | $125.89 | $234.42 |
DeanCare Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $446.68 | Facility | None | $181.97 | $181.97 | $446.68 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $812.83 | Professional | None | $181.97 | $181.97 | $812.83 |
Network Health Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Network Health Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $213.80 | Professional | None | $186.21 | $204.17 | $213.80 |
Prevea360 Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $398.11 | Professional | None | $141.25 | $194.98 | $398.11 |
Quartz Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $389.05 | Facility | None | $204.17 | $288.40 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Security Health Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $302.00 | Professional | None | $245.47 | $251.19 | $302.00 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $95.50 Median $95.50 Typical High $229.09 | Professional | 52 · Reduced service | $95.50 | $95.50 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $91.20 | Professional | 53 · Discontinued | $38.02 | $38.02 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $338.84 | Professional | 54 · Surgery only | $144.54 | $144.54 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $67.61 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $45.71 |
Where Wisconsin sits
The same service costs 3.6 times more in Wyoming than in North Carolina. 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
$186
WY $427NC $117
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.