How much rates vary
Facilitymedian $2,042 · 10th to 90th $407 to $4,365Professionalmedian $676 · 10th to 90th $263 to $1,349
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 $181.97 Median $263.03 Typical High $14,454.40 | Facility | None | $181.97 | $263.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $1,513.56 | Professional | None | $181.97 | $263.03 | $1,513.56 |
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 $331.13 Median $812.83 Typical High $1,412.54 | Professional | None | $331.13 | $812.83 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Facility | None | $645.65 | $851.14 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $933.25 | Professional | None | $239.88 | $389.05 | $933.25 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $3,090.30 Typical High $5,370.32 | Facility | None | $251.19 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $831.76 | Professional | None | $371.54 | $549.54 | $831.76 |
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 $309.03 Median $1,000.00 Typical High $2,290.87 | Professional | None | $309.03 | $1,000.00 | $2,290.87 |
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 $436.52 Median $616.60 Typical High $870.96 | Professional | None | $436.52 | $616.60 | $870.96 |
Prevea360 Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $575.44 | Facility | None | $194.98 | $323.59 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,023.29 | Professional | None | $346.74 | $645.65 | $1,023.29 |
Quartz Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,202.26 | Facility | None | $616.60 | $831.76 | $1,202.26 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $575.44 | Professional | None | $239.88 | $354.81 | $575.44 |
Security Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | None | $389.05 | $389.05 | $575.44 |
Security Health Setting Professional Modifier None Typical Low $467.74 Median $1,000.00 Typical High $1,513.56 | Professional | None | $467.74 | $1,000.00 | $1,513.56 |
The Alliance Setting Professional Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,737.80 | Professional | None | $524.81 | $1,000.00 | $1,737.80 |
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 $239.88 Median $616.60 Typical High $1,230.27 | Professional | None | $239.88 | $616.60 | $1,230.27 |
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 $91.20 Median $91.20 Typical High $131.83 | Facility | 52 · Reduced service | $91.20 | $91.20 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $52.48 | Facility | 53 · Discontinued | $36.31 | $36.31 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $199.53 | Facility | 54 · Surgery only | $134.90 | $134.90 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $39.81 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $26.30 | Facility | 56 · Pre-op care only | $18.20 | $18.20 | $26.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $125.89 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $131.83 Typical High $954.99 | Professional | 52 · Reduced service | $91.20 | $131.83 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $52.48 Typical High $380.19 | Professional | 53 · Discontinued | $36.31 | $52.48 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $1,445.44 | Professional | 54 · Surgery only | $134.90 | $199.53 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $288.40 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.30 Typical High $190.55 | Professional | 56 · Pre-op care only | $18.20 | $26.30 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $1,348.96 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $275.42 Typical High $416.87 | Professional | 51 · Multiple procedures | $186.21 | $275.42 | $416.87 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $436.52 Typical High $660.69 | Professional | 54 · Surgery only | $295.12 | $436.52 | $660.69 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $109.65 Typical High $165.96 | Professional | 55 · Aftercare only | $74.13 | $109.65 | $165.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $457.09 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $309.03 | $457.09 | $691.83 |
Where Wisconsin sits
The same service costs 3.6 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 $851KY $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.