How much rates vary
Facilitymedian $2,630 · 10th to 90th $501 to $5,754Professionalmedian $741 · 10th to 90th $282 to $1,380
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 $208.93 Median $269.15 Typical High $14,454.40 | Facility | None | $208.93 | $269.15 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $1,949.84 | Professional | None | $208.93 | $269.15 | $1,949.84 |
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 $354.81 Median $891.25 Typical High $1,412.54 | Professional | None | $354.81 | $891.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,174.90 Typical High $2,041.74 | Facility | None | $831.76 | $1,174.90 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $954.99 | Professional | None | $281.84 | $407.38 | $954.99 |
DeanCare Setting Facility Modifier None Typical Low $269.15 Median $3,090.30 Typical High $5,370.32 | Facility | None | $269.15 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $851.14 | Professional | None | $426.58 | $549.54 | $851.14 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,344.23 Typical High $4,786.30 | Facility | None | $489.78 | $2,344.23 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,000.00 Typical High $2,344.23 | Professional | None | $323.59 | $1,000.00 | $2,344.23 |
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 $436.52 Median $676.08 Typical High $870.96 | Professional | None | $436.52 | $676.08 | $870.96 |
Prevea360 Setting Facility Modifier None Typical Low $223.87 Median $346.74 Typical High $575.44 | Facility | None | $223.87 | $346.74 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $724.44 Typical High $1,096.48 | Professional | None | $398.11 | $724.44 | $1,096.48 |
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 $263.03 Median $363.08 Typical High $588.84 | Professional | None | $263.03 | $363.08 | $588.84 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
Security Health Setting Professional Modifier None Typical Low $524.81 Median $1,096.48 Typical High $1,513.56 | Professional | None | $524.81 | $1,096.48 | $1,513.56 |
The Alliance Setting Professional Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,041.74 | Professional | None | $602.56 | $1,202.26 | $2,041.74 |
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 $269.15 Median $630.96 Typical High $1,202.26 | Professional | None | $269.15 | $630.96 | $1,202.26 |
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 $104.71 Median $104.71 Typical High $134.90 | Facility | 52 · Reduced service | $104.71 | $104.71 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $53.70 | Facility | 53 · Discontinued | $41.69 | $41.69 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $204.17 | Facility | 54 · Surgery only | $158.49 | $158.49 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $40.74 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $26.92 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $134.90 Typical High $1,023.29 | Professional | 52 · Reduced service | $104.71 | $134.90 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $407.38 | Professional | 53 · Discontinued | $41.69 | $53.70 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $1,548.82 | Professional | 54 · Surgery only | $158.49 | $204.17 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $309.03 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $204.17 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $190.55 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $147.91 | $190.55 | $1,445.44 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $275.42 Typical High $416.87 | Professional | 51 · Multiple procedures | $213.80 | $275.42 | $416.87 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $346.74 | $446.68 | $676.08 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $169.82 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $169.82 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $363.08 | $467.74 | $707.95 |
Where Wisconsin sits
The same service costs 4.8 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
$891
AK $1,202KY $251
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.