How much rates vary
Facilitymedian $1,202 · 10th to 90th $129 to $3,715Professionalmedian $302 · 10th to 90th $112 to $550
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 $93.33 Median $109.65 Typical High $14,454.40 | Facility | None | $93.33 | $109.65 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $501.19 | Professional | None | $93.33 | $109.65 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $575.44 | Professional | None | $154.88 | $354.81 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $158.49 | Professional | None | $117.49 | $125.89 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $213.80 Typical High $398.11 | Facility | None | $50.12 | $213.80 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $380.19 | Professional | None | $125.89 | $245.47 | $380.19 |
DeanCare Setting Facility Modifier None Typical Low $120.23 Median $2,570.40 Typical High $4,786.30 | Facility | None | $120.23 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $346.74 | Professional | None | $190.55 | $223.87 | $346.74 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $724.44 Typical High $1,778.28 | Facility | None | $141.25 | $724.44 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $380.19 Typical High $954.99 | Professional | None | $123.03 | $380.19 | $954.99 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $331.13 | Professional | None | $169.82 | $257.04 | $331.13 |
Prevea360 Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $263.03 | Facility | None | $100.00 | $141.25 | $263.03 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $467.74 | Professional | None | $169.82 | $295.12 | $467.74 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $154.88 Typical High $234.42 | Facility | None | $50.12 | $154.88 | $234.42 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $302.00 | Professional | None | $120.23 | $204.17 | $302.00 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | None | $194.98 | $194.98 | $234.42 |
Security Health Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $602.56 | Professional | None | $213.80 | $467.74 | $602.56 |
The Alliance Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $758.58 | Professional | None | $239.88 | $354.81 | $758.58 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $467.74 | Professional | None | $104.71 | $257.04 | $467.74 |
16 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 $45.71 Median $45.71 Typical High $54.95 | Facility | 52 · Reduced service | $45.71 | $45.71 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $21.88 | Facility | 53 · Discontinued | $18.62 | $18.62 | $21.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $83.18 | Facility | 54 · Surgery only | $69.18 | $69.18 | $83.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $16.60 | Facility | 55 · Aftercare only | $13.80 | $13.80 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $10.96 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $10.96 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $64.57 Typical High $77.62 | Facility | 78 · Unplanned return to OR | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $54.95 Typical High $398.11 | Professional | 52 · Reduced service | $45.71 | $54.95 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $158.49 | Professional | 53 · Discontinued | $18.62 | $21.88 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $83.18 Typical High $602.56 | Professional | 54 · Surgery only | $69.18 | $83.18 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $120.23 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $79.43 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $77.62 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $64.57 | $77.62 | $562.34 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $112.20 Typical High $169.82 | Professional | 51 · Multiple procedures | $95.50 | $112.20 | $169.82 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $275.42 | Professional | 54 · Surgery only | $151.36 | $181.97 | $275.42 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $69.18 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $69.18 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $288.40 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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
$331
AK $437KY $100
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.