How much rates vary
Facilitymedian $1,950 · 10th to 90th $309 to $4,365Professionalmedian $617 · 10th to 90th $240 to $1,202
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 $165.96 Median $239.88 Typical High $14,454.40 | Facility | None | $165.96 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $1,096.48 | Professional | None | $165.96 | $239.88 | $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 $302.00 Median $741.31 Typical High $1,258.93 | Professional | None | $302.00 | $741.31 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $346.74 | Professional | None | $257.04 | $275.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,096.48 | Facility | None | $288.40 | $630.96 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $831.76 | Professional | None | $218.78 | $346.74 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $2,570.40 Typical High $4,786.30 | Facility | None | $229.09 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $741.31 | Professional | None | $338.84 | $489.78 | $741.31 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,548.82 Typical High $3,630.78 | Facility | None | $371.54 | $1,548.82 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $891.25 Typical High $2,089.30 | Professional | None | $288.40 | $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 $562.34 Typical High $794.33 | Professional | None | $389.05 | $562.34 | $794.33 |
Prevea360 Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $575.44 | Facility | None | $177.83 | $288.40 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $912.01 | Professional | None | $309.03 | $575.44 | $912.01 |
Quartz Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $1,071.52 | Facility | None | $288.40 | $416.87 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $512.86 | Professional | None | $218.78 | $316.23 | $512.86 |
Security Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $524.81 | Professional | None | $354.81 | $354.81 | $524.81 |
Security Health Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,348.96 | Professional | None | $426.58 | $912.01 | $1,348.96 |
The Alliance Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,445.44 | Professional | None | $512.86 | $891.25 | $1,445.44 |
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 $218.78 Median $562.34 Typical High $1,096.48 | Professional | None | $218.78 | $562.34 | $1,096.48 |
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 $83.18 Median $83.18 Typical High $120.23 | Facility | 52 · Reduced service | $83.18 | $83.18 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $47.86 | Facility | 53 · Discontinued | $33.11 | $33.11 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $177.83 | Facility | 54 · Surgery only | $123.03 | $123.03 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $35.48 | Facility | 55 · Aftercare only | $24.55 | $24.55 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $23.99 | Facility | 56 · Pre-op care only | $16.60 | $16.60 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $120.23 Typical High $630.96 | Professional | 52 · Reduced service | $83.18 | $120.23 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $251.19 | Professional | 53 · Discontinued | $33.11 | $47.86 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $177.83 Typical High $933.25 | Professional | 54 · Surgery only | $123.03 | $177.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $35.48 Typical High $186.21 | Professional | 55 · Aftercare only | $24.55 | $35.48 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $125.89 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $165.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $114.82 | $165.96 | $870.96 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $245.47 Typical High $371.54 | Professional | 51 · Multiple procedures | $169.82 | $245.47 | $371.54 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $389.05 Typical High $602.56 | Professional | 54 · Surgery only | $269.15 | $389.05 | $602.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $97.72 Typical High $147.91 | Professional | 55 · Aftercare only | $67.61 | $97.72 | $147.91 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $416.87 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $281.84 | $416.87 | $630.96 |
Where Wisconsin sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$692
AK $776TX $214
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.