How much rates vary
Facilitymedian $1,950 · 10th to 90th $224 to $4,365Professionalmedian $447 · 10th to 90th $170 to $851
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 $125.89 Median $165.96 Typical High $14,454.40 | Facility | None | $125.89 | $165.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $1,096.48 | Professional | None | $125.89 | $165.96 | $1,096.48 |
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 $213.80 Median $537.03 Typical High $870.96 | Professional | None | $213.80 | $537.03 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $239.88 | Professional | None | $177.83 | $190.55 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $512.86 Typical High $870.96 | Facility | None | $218.78 | $512.86 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $588.84 | Professional | None | $169.82 | $257.04 | $588.84 |
DeanCare Setting Facility Modifier None Typical Low $165.96 Median $2,570.40 Typical High $4,786.30 | Facility | None | $165.96 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $512.86 | Professional | None | $263.03 | $338.84 | $512.86 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,548.82 Typical High $3,630.78 | Facility | None | $295.12 | $1,548.82 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $602.56 Typical High $1,445.44 | Professional | None | $194.98 | $602.56 | $1,445.44 |
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 $269.15 Median $416.87 Typical High $537.03 | Professional | None | $269.15 | $416.87 | $537.03 |
Prevea360 Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $398.11 | Facility | None | $134.90 | $213.80 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $426.58 Typical High $645.65 | Professional | None | $229.09 | $426.58 | $645.65 |
Quartz Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $1,071.52 | Facility | None | $213.80 | $323.59 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $354.81 | Professional | None | $169.82 | $218.78 | $354.81 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $933.25 | Professional | None | $316.23 | $676.08 | $933.25 |
The Alliance Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $977.24 | Professional | None | $269.15 | $616.60 | $977.24 |
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 $158.49 Median $380.19 Typical High $724.44 | Professional | None | $158.49 | $380.19 | $724.44 |
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 $63.10 Median $63.10 Typical High $83.18 | Facility | 52 · Reduced service | $63.10 | $63.10 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $33.11 | Facility | 53 · Discontinued | $25.12 | $25.12 | $33.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $123.03 | Facility | 54 · Surgery only | $95.50 | $95.50 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $24.55 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.60 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $16.60 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $114.82 | Facility | 78 · Unplanned return to OR | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $83.18 Typical High $676.08 | Professional | 52 · Reduced service | $63.10 | $83.18 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $269.15 | Professional | 53 · Discontinued | $25.12 | $33.11 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $123.03 Typical High $1,000.00 | Professional | 54 · Surgery only | $95.50 | $123.03 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $24.55 Typical High $199.53 | Professional | 55 · Aftercare only | $19.05 | $24.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $134.90 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $114.82 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $89.13 | $114.82 | $933.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $169.82 Typical High $257.04 | Professional | 51 · Multiple procedures | $128.82 | $169.82 | $257.04 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $275.42 Typical High $416.87 | Professional | 54 · Surgery only | $208.93 | $275.42 | $416.87 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $102.33 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $102.33 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $288.40 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $218.78 | $288.40 | $436.52 |
Where Wisconsin sits
The same service costs 3.9 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
$513
AK $603KY $155
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.