How much rates vary
Facilitymedian $2,630 · 10th to 90th $525 to $5,623Professionalmedian $589 · 10th to 90th $229 to $1,148
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 $154.88 Median $223.87 Typical High $14,454.40 | Facility | None | $154.88 | $223.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $1,621.81 | Professional | None | $154.88 | $223.87 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $691.83 Typical High $1,174.90 | Professional | None | $288.40 | $691.83 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,122.02 Typical High $2,041.74 | Facility | None | $707.95 | $1,122.02 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $794.33 | Professional | None | $257.04 | $478.63 | $794.33 |
DeanCare Setting Facility Modifier None Typical Low $213.80 Median $2,570.40 Typical High $4,786.30 | Facility | None | $213.80 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $707.95 | Professional | None | $323.59 | $467.74 | $707.95 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $2,187.76 Typical High $4,786.30 | Facility | None | $380.19 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $870.96 Typical High $1,949.84 | Professional | None | $281.84 | $870.96 | $1,949.84 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $758.58 | Professional | None | $371.54 | $537.03 | $758.58 |
Prevea360 Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $537.03 | Facility | None | $165.96 | $275.42 | $537.03 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $575.44 Typical High $912.01 | Professional | None | $302.00 | $575.44 | $912.01 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $2,187.76 | Facility | None | $724.44 | $1,380.38 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $512.86 | Professional | None | $251.19 | $346.74 | $512.86 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | None | $338.84 | $338.84 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $870.96 Typical High $1,318.26 | Professional | None | $398.11 | $870.96 | $1,318.26 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $213.80 Median $524.81 Typical High $1,071.52 | Professional | None | $213.80 | $524.81 | $1,071.52 |
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 $77.62 Median $77.62 Typical High $112.20 | Facility | 52 · Reduced service | $77.62 | $77.62 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $44.67 | Facility | 53 · Discontinued | $30.90 | $30.90 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $169.82 | Facility | 54 · Surgery only | $117.49 | $117.49 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $33.88 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $22.39 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $22.39 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $158.49 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $112.20 Typical High $891.25 | Professional | 52 · Reduced service | $77.62 | $112.20 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $44.67 Typical High $354.81 | Professional | 53 · Discontinued | $30.90 | $44.67 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $1,318.26 | Professional | 54 · Surgery only | $117.49 | $169.82 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $269.15 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.39 Typical High $177.83 | Professional | 56 · Pre-op care only | $15.49 | $22.39 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $1,230.27 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $229.09 Typical High $354.81 | Professional | 51 · Multiple procedures | $158.49 | $229.09 | $354.81 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $371.54 Typical High $562.34 | Professional | 54 · Surgery only | $257.04 | $371.54 | $562.34 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $93.33 Typical High $141.25 | Professional | 55 · Aftercare only | $64.57 | $93.33 | $141.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $389.05 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $269.15 | $389.05 | $588.84 |
Where Wisconsin sits
The same service costs 4.2 times more in Alaska than in Utah. 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
$692
AK $891UT $214
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.