How much rates vary
Facilitymedian $2,239 · 10th to 90th $407 to $5,248Professionalmedian $676 · 10th to 90th $257 to $1,230
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 $194.98 Median $239.88 Typical High $14,454.40 | Facility | None | $194.98 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $1,778.28 | Professional | None | $194.98 | $239.88 | $1,778.28 |
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 $331.13 Median $812.83 Typical High $1,288.25 | Professional | None | $331.13 | $812.83 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,862.09 | Facility | None | $707.95 | $1,096.48 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $851.14 | Professional | None | $257.04 | $371.54 | $851.14 |
DeanCare Setting Facility Modifier None Typical Low $257.04 Median $2,570.40 Typical High $4,786.30 | Facility | None | $257.04 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $758.58 | Professional | None | $398.11 | $501.19 | $758.58 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,548.82 Typical High $3,981.07 | Facility | None | $371.54 | $1,548.82 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $891.25 Typical High $2,089.30 | Professional | None | $295.12 | $891.25 | $2,089.30 |
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 $389.05 Median $630.96 Typical High $794.33 | Professional | None | $389.05 | $630.96 | $794.33 |
Prevea360 Setting Facility Modifier None Typical Low $208.93 Median $309.03 Typical High $575.44 | Facility | None | $208.93 | $309.03 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $977.24 | Professional | None | $346.74 | $645.65 | $977.24 |
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 $257.04 Median $323.59 Typical High $549.54 | Professional | None | $257.04 | $323.59 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $537.03 | Professional | None | $416.87 | $416.87 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $1,000.00 Typical High $1,380.38 | Professional | None | $489.78 | $1,000.00 | $1,380.38 |
The Alliance Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
United Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $1,071.52 | Professional | None | $245.47 | $562.34 | $1,071.52 |
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 $97.72 Median $97.72 Typical High $120.23 | Facility | 52 · Reduced service | $97.72 | $97.72 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $47.86 | Facility | 53 · Discontinued | $38.90 | $38.90 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $181.97 | Facility | 54 · Surgery only | $144.54 | $144.54 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $36.31 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $23.99 | Facility | 56 · Pre-op care only | $19.50 | $19.50 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $120.23 Typical High $977.24 | Professional | 52 · Reduced service | $97.72 | $120.23 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $389.05 | Professional | 53 · Discontinued | $38.90 | $47.86 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $1,445.44 | Professional | 54 · Surgery only | $144.54 | $181.97 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $288.40 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $194.98 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $134.90 | $169.82 | $1,348.96 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $199.53 Median $251.19 Typical High $380.19 | Professional | 51 · Multiple procedures | $199.53 | $251.19 | $380.19 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $602.56 | Professional | 54 · Surgery only | $316.23 | $398.11 | $602.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $151.36 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $151.36 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $416.87 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $331.13 | $416.87 | $630.96 |
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
$794
AK $912KY $234
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.