How much rates vary
Facilitymedian $1,950 · 10th to 90th $295 to $4,365Professionalmedian $537 · 10th to 90th $214 to $1,096
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 $144.54 Median $218.78 Typical High $14,454.40 | Facility | None | $144.54 | $218.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $1,148.15 | Professional | None | $144.54 | $218.78 | $1,148.15 |
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 $269.15 Median $645.65 Typical High $1,122.02 | Professional | None | $269.15 | $645.65 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $602.56 Typical High $1,071.52 | Facility | None | $275.42 | $602.56 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $758.58 | Professional | None | $194.98 | $309.03 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $199.53 Median $2,570.40 Typical High $4,786.30 | Facility | None | $199.53 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $676.08 | Professional | None | $295.12 | $446.68 | $676.08 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,548.82 Typical High $3,630.78 | Facility | None | $346.74 | $1,548.82 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $812.83 Typical High $1,905.46 | Professional | None | $263.03 | $812.83 | $1,905.46 |
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 $354.81 Median $501.19 Typical High $724.44 | Professional | None | $354.81 | $501.19 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $154.88 Median $275.42 Typical High $524.81 | Facility | None | $154.88 | $275.42 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $275.42 Median $524.81 Typical High $831.76 | Professional | None | $275.42 | $524.81 | $831.76 |
Quartz Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $1,071.52 | Facility | None | $269.15 | $407.38 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $467.74 | Professional | None | $194.98 | $288.40 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | None | $309.03 | $309.03 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $812.83 Typical High $1,230.27 | Professional | None | $398.11 | $812.83 | $1,230.27 |
The Alliance Setting Professional Modifier None Typical Low $295.12 Median $676.08 Typical High $1,380.38 | Professional | None | $295.12 | $676.08 | $1,380.38 |
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 $190.55 Median $489.78 Typical High $1,000.00 | Professional | None | $190.55 | $489.78 | $1,000.00 |
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 $72.44 Median $72.44 Typical High $107.15 | Facility | 52 · Reduced service | $72.44 | $72.44 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $43.65 | Facility | 53 · Discontinued | $28.84 | $28.84 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $162.18 | Facility | 54 · Surgery only | $109.65 | $109.65 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $32.36 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $21.88 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $107.15 Typical High $741.31 | Professional | 52 · Reduced service | $72.44 | $107.15 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $43.65 Typical High $295.12 | Professional | 53 · Discontinued | $28.84 | $43.65 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $1,122.02 | Professional | 54 · Surgery only | $109.65 | $162.18 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $223.87 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.88 Typical High $147.91 | Professional | 56 · Pre-op care only | $14.45 | $21.88 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $1,047.13 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | 51 · Multiple procedures | $147.91 | $223.87 | $338.84 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $239.88 | $354.81 | $537.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $58.88 | $89.13 | $134.90 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $371.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $251.19 | $371.54 | $562.34 |
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
$631
AK $692KY $204
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.