How much rates vary
Facilitymedian $1,202 · 10th to 90th $209 to $3,802Professionalmedian $550 · 10th to 90th $200 to $933
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 $158.49 Median $181.97 Typical High $14,454.40 | Facility | None | $158.49 | $181.97 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $954.99 | Professional | None | $158.49 | $181.97 | $954.99 |
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 $269.15 Median $616.60 Typical High $954.99 | Professional | None | $269.15 | $616.60 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $269.15 | Professional | None | $194.98 | $213.80 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $537.03 Typical High $870.96 | Facility | None | $218.78 | $537.03 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $645.65 | Professional | None | $218.78 | $407.38 | $645.65 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $2,570.40 Typical High $4,786.30 | Facility | None | $204.17 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $575.44 | Professional | None | $323.59 | $380.19 | $575.44 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $2,041.74 | Facility | None | $204.17 | $912.01 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $660.69 Typical High $1,584.89 | Professional | None | $213.80 | $660.69 | $1,584.89 |
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 $288.40 Median $446.68 Typical High $575.44 | Professional | None | $288.40 | $446.68 | $575.44 |
Prevea360 Setting Facility Modifier None Typical Low $169.82 Median $234.42 Typical High $436.52 | Facility | None | $169.82 | $234.42 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $794.33 | Professional | None | $288.40 | $512.86 | $794.33 |
Quartz Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $831.76 | Facility | None | $213.80 | $323.59 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $446.68 | Professional | None | $208.93 | $346.74 | $446.68 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | None | $338.84 | $338.84 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $371.54 Median $812.83 Typical High $1,023.29 | Professional | None | $371.54 | $812.83 | $1,023.29 |
The Alliance Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
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 $186.21 Median $436.52 Typical High $794.33 | Professional | None | $186.21 | $436.52 | $794.33 |
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 $79.43 Median $79.43 Typical High $91.20 | Facility | 52 · Reduced service | $79.43 | $79.43 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $36.31 | Facility | 53 · Discontinued | $31.62 | $31.62 | $36.31 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $138.04 | Facility | 54 · Surgery only | $117.49 | $117.49 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $27.54 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $18.20 | Facility | 56 · Pre-op care only | $15.85 | $15.85 | $18.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $128.82 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $91.20 Typical High $478.63 | Professional | 52 · Reduced service | $79.43 | $91.20 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $194.98 | Professional | 53 · Discontinued | $31.62 | $36.31 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $724.44 | Professional | 54 · Surgery only | $117.49 | $138.04 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $144.54 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $676.08 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $186.21 Typical High $288.40 | Professional | 51 · Multiple procedures | $162.18 | $186.21 | $288.40 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $457.09 | Professional | 54 · Surgery only | $257.04 | $302.00 | $457.09 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $114.82 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $114.82 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $478.63 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska than in Florida. 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
$575
AK $759FL $174
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.