How much rates vary
Facilitymedian $1,585 · 10th to 90th $200 to $4,365Professionalmedian $363 · 10th to 90th $148 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 $100.00 Median $147.91 Typical High $14,454.40 | Facility | None | $100.00 | $147.91 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $630.96 | Professional | None | $100.00 | $147.91 | $630.96 |
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 $181.97 Median $436.52 Typical High $724.44 | Professional | None | $181.97 | $436.52 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $213.80 | Professional | None | $158.49 | $169.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $457.09 Typical High $831.76 | Facility | None | $199.53 | $457.09 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $512.86 | Professional | None | $131.83 | $213.80 | $512.86 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $2,570.40 Typical High $4,786.30 | Facility | None | $138.04 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $457.09 | Professional | None | $204.17 | $302.00 | $457.09 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $1,479.11 Typical High $3,630.78 | Facility | None | $229.09 | $1,479.11 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $537.03 Typical High $1,288.25 | Professional | None | $173.78 | $537.03 | $1,288.25 |
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 $239.88 Median $323.59 Typical High $467.74 | Professional | None | $239.88 | $323.59 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $354.81 | Facility | None | $102.33 | $173.78 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $562.34 | Professional | None | $190.55 | $354.81 | $562.34 |
Quartz Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $1,071.52 | Facility | None | $194.98 | $295.12 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $316.23 | Professional | None | $131.83 | $194.98 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $323.59 | Professional | None | $213.80 | $213.80 | $323.59 |
Security Health Setting Professional Modifier None Typical Low $245.47 Median $549.54 Typical High $831.76 | Professional | None | $245.47 | $549.54 | $831.76 |
The Alliance Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $933.25 | Professional | None | $316.23 | $524.81 | $933.25 |
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 $128.82 Median $331.13 Typical High $645.65 | Professional | None | $128.82 | $331.13 | $645.65 |
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 $50.12 Median $50.12 Typical High $74.13 | Facility | 52 · Reduced service | $50.12 | $50.12 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $29.51 | Facility | 53 · Discontinued | $19.95 | $19.95 | $29.51 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $109.65 | Facility | 54 · Surgery only | $74.13 | $74.13 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $21.88 | Facility | 55 · Aftercare only | $14.79 | $14.79 | $21.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $14.79 | Facility | 56 · Pre-op care only | $10.00 | $10.00 | $14.79 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $69.18 Typical High $102.33 | Facility | 78 · Unplanned return to OR | $69.18 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $74.13 Typical High $501.19 | Professional | 52 · Reduced service | $50.12 | $74.13 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $29.51 Typical High $199.53 | Professional | 53 · Discontinued | $19.95 | $29.51 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $109.65 Typical High $741.31 | Professional | 54 · Surgery only | $74.13 | $109.65 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.88 Typical High $147.91 | Professional | 55 · Aftercare only | $14.79 | $21.88 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.79 Typical High $100.00 | Professional | 56 · Pre-op care only | $10.00 | $14.79 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $102.33 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $69.18 | $102.33 | $691.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $102.33 Median $151.36 Typical High $229.09 | Professional | 51 · Multiple procedures | $102.33 | $151.36 | $229.09 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $239.88 Typical High $371.54 | Professional | 54 · Surgery only | $162.18 | $239.88 | $371.54 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $60.26 Typical High $91.20 | Professional | 55 · Aftercare only | $40.74 | $60.26 | $91.20 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $257.04 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $173.78 | $257.04 | $389.05 |
Where Wisconsin sits
The same service costs 3.8 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
$437
AK $525KY $138
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.