How much rates vary
Facilitymedian $2,630 · 10th to 90th $468 to $5,754Professionalmedian $550 · 10th to 90th $209 to $1,023
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 $204.17 Typical High $14,454.40 | Facility | None | $154.88 | $204.17 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $1,513.56 | Professional | None | $154.88 | $204.17 | $1,513.56 |
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 $263.03 Median $660.69 Typical High $1,071.52 | Professional | None | $263.03 | $660.69 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,071.52 Typical High $2,041.74 | Facility | None | $630.96 | $1,071.52 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $707.95 | Professional | None | $208.93 | $302.00 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $213.80 Median $3,090.30 Typical High $5,370.32 | Facility | None | $213.80 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $630.96 | Professional | None | $316.23 | $416.87 | $630.96 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $2,187.76 Typical High $4,786.30 | Facility | None | $371.54 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $741.31 Typical High $1,778.28 | Professional | None | $239.88 | $741.31 | $1,778.28 |
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 $323.59 Median $512.86 Typical High $660.69 | Professional | None | $323.59 | $512.86 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $165.96 Median $263.03 Typical High $489.78 | Facility | None | $165.96 | $263.03 | $489.78 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $812.83 | Professional | None | $288.40 | $524.81 | $812.83 |
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 $208.93 Median $269.15 Typical High $436.52 | Professional | None | $208.93 | $269.15 | $436.52 |
Security Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | None | $323.59 | $323.59 | $436.52 |
Security Health Setting Professional Modifier None Typical Low $389.05 Median $831.76 Typical High $1,122.02 | Professional | None | $389.05 | $831.76 | $1,122.02 |
The Alliance Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $977.24 | Professional | None | $446.68 | $446.68 | $977.24 |
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 $194.98 Median $467.74 Typical High $891.25 | Professional | None | $194.98 | $467.74 | $891.25 |
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 $102.33 | Facility | 52 · Reduced service | $77.62 | $77.62 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $40.74 | Facility | 53 · Discontinued | $30.90 | $30.90 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $151.36 | Facility | 54 · Surgery only | $117.49 | $117.49 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $30.20 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $20.42 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $20.42 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $141.25 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $102.33 Typical High $831.76 | Professional | 52 · Reduced service | $77.62 | $102.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $331.13 | Professional | 53 · Discontinued | $30.90 | $40.74 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $1,258.93 | Professional | 54 · Surgery only | $117.49 | $151.36 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $251.19 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $165.96 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $1,174.90 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $208.93 Typical High $316.23 | Professional | 51 · Multiple procedures | $158.49 | $208.93 | $316.23 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $512.86 | Professional | 54 · Surgery only | $257.04 | $331.13 | $512.86 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $83.18 Typical High $125.89 | Professional | 55 · Aftercare only | $63.10 | $83.18 | $125.89 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $354.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $269.15 | $354.81 | $537.03 |
Where Wisconsin sits
The same service costs 4.7 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
$661
AK $871KY $186
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.