How much rates vary
Facilitymedian $1,995 · 10th to 90th $186 to $4,365Professionalmedian $347 · 10th to 90th $138 to $692
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 $93.33 Median $138.04 Typical High $14,454.40 | Facility | None | $93.33 | $138.04 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $812.83 | Professional | None | $93.33 | $138.04 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $724.44 | Professional | None | $173.78 | $416.87 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $194.98 | Professional | None | $147.91 | $158.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $426.58 Typical High $794.33 | Facility | None | $177.83 | $426.58 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $478.63 | Professional | None | $125.89 | $199.53 | $478.63 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $2,570.40 Typical High $4,786.30 | Facility | None | $128.82 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $426.58 | Professional | None | $194.98 | $281.84 | $426.58 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $1,479.11 Typical High $3,630.78 | Facility | None | $223.87 | $1,479.11 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $501.19 Typical High $1,202.26 | Professional | None | $162.18 | $501.19 | $1,202.26 |
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 $316.23 Typical High $446.68 | Professional | None | $223.87 | $316.23 | $446.68 |
Prevea360 Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $331.13 | Facility | None | $100.00 | $165.96 | $331.13 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $524.81 | Professional | None | $177.83 | $331.13 | $524.81 |
Quartz Setting Facility Modifier None Typical Low $173.78 Median $269.15 Typical High $1,071.52 | Facility | None | $173.78 | $269.15 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $295.12 | Professional | None | $125.89 | $181.97 | $295.12 |
Security Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $302.00 | Professional | None | $204.17 | $204.17 | $302.00 |
Security Health Setting Professional Modifier None Typical Low $239.88 Median $524.81 Typical High $776.25 | Professional | None | $239.88 | $524.81 | $776.25 |
The Alliance Setting Professional Modifier None Typical Low $234.42 Median $467.74 Typical High $758.58 | Professional | None | $234.42 | $467.74 | $758.58 |
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 $123.03 Median $316.23 Typical High $616.60 | Professional | None | $123.03 | $316.23 | $616.60 |
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 $46.77 Median $46.77 Typical High $67.61 | Facility | 52 · Reduced service | $46.77 | $46.77 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $27.54 | Facility | 53 · Discontinued | $19.05 | $19.05 | $27.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $102.33 | Facility | 54 · Surgery only | $70.79 | $70.79 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $20.42 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $13.80 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $13.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $66.07 Typical High $95.50 | Facility | 78 · Unplanned return to OR | $66.07 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $67.61 Typical High $537.03 | Professional | 52 · Reduced service | $46.77 | $67.61 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $27.54 Typical High $213.80 | Professional | 53 · Discontinued | $19.05 | $27.54 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $794.33 | Professional | 54 · Surgery only | $70.79 | $102.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $158.49 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.80 Typical High $107.15 | Professional | 56 · Pre-op care only | $9.33 | $13.80 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $95.50 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $66.07 | $95.50 | $741.31 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $141.25 Typical High $213.80 | Professional | 51 · Multiple procedures | $97.72 | $141.25 | $213.80 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $223.87 Typical High $338.84 | Professional | 54 · Surgery only | $154.88 | $223.87 | $338.84 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $85.11 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $85.11 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $234.42 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $162.18 | $234.42 | $354.81 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$417
AK $447FL $126
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.