How much rates vary
Facilitymedian $2,570 · 10th to 90th $427 to $5,754Professionalmedian $501 · 10th to 90th $191 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 $141.25 Median $190.55 Typical High $14,454.40 | Facility | None | $141.25 | $190.55 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $1,122.02 | Professional | None | $141.25 | $190.55 | $1,122.02 |
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 $239.88 Median $616.60 Typical High $1,000.00 | Professional | None | $239.88 | $616.60 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,862.09 | Facility | None | $602.56 | $1,071.52 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $676.08 | Professional | None | $186.21 | $281.84 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $194.98 Median $2,570.40 Typical High $4,786.30 | Facility | None | $194.98 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $602.56 | Professional | None | $288.40 | $389.05 | $602.56 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $2,187.76 Typical High $5,128.61 | Facility | None | $338.84 | $2,187.76 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $691.83 Typical High $1,659.59 | Professional | None | $229.09 | $691.83 | $1,659.59 |
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 $309.03 Median $457.09 Typical High $616.60 | Professional | None | $309.03 | $457.09 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $457.09 | Facility | None | $151.36 | $245.47 | $457.09 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $758.58 | Professional | None | $263.03 | $489.78 | $758.58 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $2,041.74 | Facility | None | $630.96 | $1,348.96 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $407.38 | Professional | None | $186.21 | $257.04 | $407.38 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $776.25 Typical High $1,096.48 | Professional | None | $346.74 | $776.25 | $1,096.48 |
The Alliance Setting Professional Modifier None Typical Low $302.00 Median $741.31 Typical High $1,258.93 | Professional | None | $302.00 | $741.31 | $1,258.93 |
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 $177.83 Median $446.68 Typical High $831.76 | Professional | None | $177.83 | $446.68 | $831.76 |
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 $70.79 Median $70.79 Typical High $95.50 | Facility | 52 · Reduced service | $70.79 | $70.79 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $38.02 | Facility | 53 · Discontinued | $28.18 | $28.18 | $38.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $144.54 | Facility | 54 · Surgery only | $104.71 | $104.71 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $28.84 | Facility | 55 · Aftercare only | $20.89 | $20.89 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $19.05 | Facility | 56 · Pre-op care only | $14.13 | $14.13 | $19.05 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $97.72 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $95.50 Typical High $776.25 | Professional | 52 · Reduced service | $70.79 | $95.50 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $309.03 | Professional | 53 · Discontinued | $28.18 | $38.02 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $1,148.15 | Professional | 54 · Surgery only | $104.71 | $144.54 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $229.09 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $154.88 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $1,071.52 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $194.98 Typical High $295.12 | Professional | 51 · Multiple procedures | $144.54 | $194.98 | $295.12 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $229.09 | $316.23 | $478.63 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $79.43 Typical High $120.23 | Professional | 55 · Aftercare only | $57.54 | $79.43 | $120.23 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $331.13 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $245.47 | $331.13 | $501.19 |
Where Wisconsin sits
The same service costs 4.6 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
$617
AK $794KY $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.