How much rates vary
Facilitymedian $1,622 · 10th to 90th $269 to $4,365Professionalmedian $479 · 10th to 90th $195 to $1,000
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 $128.82 Median $194.98 Typical High $14,454.40 | Facility | None | $128.82 | $194.98 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $1,202.26 | Professional | None | $128.82 | $194.98 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $575.44 Typical High $1,023.29 | Professional | None | $239.88 | $575.44 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $1,047.13 | Facility | None | $257.04 | $549.54 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $691.83 | Professional | None | $169.82 | $281.84 | $691.83 |
DeanCare Setting Facility Modifier None Typical Low $177.83 Median $2,570.40 Typical High $4,786.30 | Facility | None | $177.83 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $616.60 | Professional | None | $263.03 | $407.38 | $616.60 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $1,548.82 Typical High $3,630.78 | Facility | None | $323.59 | $1,548.82 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $741.31 Typical High $1,698.24 | Professional | None | $234.42 | $741.31 | $1,698.24 |
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 $323.59 Median $436.52 Typical High $645.65 | Professional | None | $323.59 | $436.52 | $645.65 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $245.47 Typical High $478.63 | Facility | None | $138.04 | $245.47 | $478.63 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $758.58 | Professional | None | $251.19 | $457.09 | $758.58 |
Quartz Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $1,071.52 | Facility | None | $251.19 | $389.05 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $416.87 | Professional | None | $169.82 | $257.04 | $416.87 |
Security Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $436.52 | Professional | None | $275.42 | $275.42 | $436.52 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $707.95 Typical High $1,122.02 | Professional | None | $338.84 | $707.95 | $1,122.02 |
The Alliance Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $1,513.56 | Professional | None | $426.58 | $741.31 | $1,513.56 |
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 $169.82 Median $446.68 Typical High $891.25 | Professional | None | $169.82 | $446.68 | $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 $64.57 Median $64.57 Typical High $97.72 | Facility | 52 · Reduced service | $64.57 | $64.57 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $38.90 | Facility | 53 · Discontinued | $25.70 | $25.70 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $147.91 | Facility | 54 · Surgery only | $95.50 | $95.50 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $29.51 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $19.50 | Facility | 56 · Pre-op care only | $12.88 | $12.88 | $19.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $138.04 | Facility | 78 · Unplanned return to OR | $89.13 | $89.13 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $97.72 Typical High $660.69 | Professional | 52 · Reduced service | $64.57 | $97.72 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.90 Typical High $263.03 | Professional | 53 · Discontinued | $25.70 | $38.90 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $1,000.00 | Professional | 54 · Surgery only | $95.50 | $147.91 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $199.53 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.50 Typical High $131.83 | Professional | 56 · Pre-op care only | $12.88 | $19.50 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $138.04 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $89.13 | $138.04 | $933.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $199.53 Typical High $309.03 | Professional | 51 · Multiple procedures | $131.83 | $199.53 | $309.03 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $323.59 Typical High $489.78 | Professional | 54 · Surgery only | $208.93 | $323.59 | $489.78 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $81.28 Typical High $123.03 | Professional | 55 · Aftercare only | $52.48 | $81.28 | $123.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $338.84 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $218.78 | $338.84 | $512.86 |
Where Wisconsin sits
The same service costs 3.4 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
$562
AK $603KY $178
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.