How much rates vary
Facilitymedian $1,585 · 10th to 90th $214 to $4,365Professionalmedian $398 · 10th to 90th $151 to $955
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 $89.13 Median $208.93 Typical High $14,454.40 | Facility | None | $89.13 | $208.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $208.93 Typical High $1,071.52 | Professional | None | $89.13 | $208.93 | $1,071.52 |
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 $186.21 Median $457.09 Typical High $977.24 | Professional | None | $186.21 | $457.09 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $562.34 Typical High $776.25 | Facility | None | $50.12 | $562.34 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $758.58 | Professional | None | $147.91 | $316.23 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $114.82 Median $2,630.27 Typical High $5,128.61 | Facility | None | $114.82 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $616.60 | Professional | None | $186.21 | $331.13 | $616.60 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $1,479.11 Typical High $3,019.95 | Facility | None | $269.15 | $1,479.11 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $588.84 Typical High $1,862.09 | Professional | None | $204.17 | $588.84 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $562.34 | Professional | None | $223.87 | $338.84 | $562.34 |
Prevea360 Setting Facility Modifier None Typical Low $87.10 Median $199.53 Typical High $380.19 | Facility | None | $87.10 | $199.53 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $457.09 Typical High $891.25 | Professional | None | $229.09 | $457.09 | $891.25 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $407.38 Typical High $616.60 | Facility | None | $50.12 | $407.38 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $467.74 | Professional | None | $138.04 | $218.78 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $489.78 | Professional | None | $194.98 | $194.98 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $223.87 Median $501.19 Typical High $1,202.26 | Professional | None | $223.87 | $501.19 | $1,202.26 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $117.49 Median $338.84 Typical High $758.58 | Professional | None | $117.49 | $338.84 | $758.58 |
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 $44.67 Median $44.67 Typical High $104.71 | Facility | 52 · Reduced service | $44.67 | $44.67 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $41.69 | Facility | 53 · Discontinued | $17.78 | $17.78 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $158.49 | Facility | 54 · Surgery only | $67.61 | $67.61 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $31.62 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $20.89 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $63.10 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $63.10 | $63.10 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $104.71 Typical High $575.44 | Professional | 52 · Reduced service | $44.67 | $104.71 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $41.69 Typical High $229.09 | Professional | 53 · Discontinued | $17.78 | $41.69 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $158.49 Typical High $851.14 | Professional | 54 · Surgery only | $67.61 | $158.49 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $31.62 Typical High $173.78 | Professional | 55 · Aftercare only | $13.49 | $31.62 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $20.89 Typical High $114.82 | Professional | 56 · Pre-op care only | $8.91 | $20.89 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $147.91 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $63.10 | $147.91 | $794.33 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $165.96 Typical High $309.03 | Professional | 51 · Multiple procedures | $91.20 | $165.96 | $309.03 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $269.15 Typical High $489.78 | Professional | 54 · Surgery only | $147.91 | $269.15 | $489.78 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $67.61 Typical High $123.03 | Professional | 55 · Aftercare only | $37.15 | $67.61 | $123.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $281.84 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $154.88 | $281.84 | $512.86 |
Where Wisconsin sits
The same service costs 4.1 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
$468
AK $501KY $123
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.