How much rates vary
Facilitymedian $2,042 · 10th to 90th $302 to $5,248Professionalmedian $661 · 10th to 90th $251 to $1,288
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 $177.83 Median $251.19 Typical High $14,454.40 | Facility | None | $177.83 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $1,659.59 | Professional | None | $177.83 | $251.19 | $1,659.59 |
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 $323.59 Median $794.33 Typical High $1,318.26 | Professional | None | $323.59 | $794.33 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $457.09 Typical High $912.01 | Facility | None | $50.12 | $457.09 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $891.25 | Professional | None | $239.88 | $371.54 | $891.25 |
DeanCare Setting Facility Modifier None Typical Low $245.47 Median $2,570.40 Typical High $4,786.30 | Facility | None | $245.47 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $794.33 | Professional | None | $363.08 | $524.81 | $794.33 |
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 $309.03 Median $954.99 Typical High $2,187.76 | Professional | None | $309.03 | $954.99 | $2,187.76 |
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 $407.38 Median $616.60 Typical High $851.14 | Professional | None | $407.38 | $616.60 | $851.14 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $323.59 Typical High $575.44 | Facility | None | $190.55 | $323.59 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $977.24 | Professional | None | $331.13 | $616.60 | $977.24 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $549.54 | Facility | None | $50.12 | $338.84 | $549.54 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $537.03 | Professional | None | $239.88 | $338.84 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $549.54 | Professional | None | $380.19 | $380.19 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $1,000.00 Typical High $1,445.44 | Professional | None | $489.78 | $1,000.00 | $1,445.44 |
The Alliance Setting Professional Modifier None Typical Low $416.87 Median $851.14 Typical High $1,737.80 | Professional | None | $416.87 | $851.14 | $1,737.80 |
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 $239.88 Median $588.84 Typical High $1,174.90 | Professional | None | $239.88 | $588.84 | $1,174.90 |
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 $89.13 Median $89.13 Typical High $125.89 | Facility | 52 · Reduced service | $89.13 | $89.13 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $50.12 | Facility | 53 · Discontinued | $35.48 | $35.48 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $190.55 | Facility | 54 · Surgery only | $134.90 | $134.90 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $38.02 | Facility | 55 · Aftercare only | $26.92 | $26.92 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $25.12 | Facility | 56 · Pre-op care only | $17.78 | $17.78 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $125.89 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $125.89 Typical High $912.01 | Professional | 52 · Reduced service | $89.13 | $125.89 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $363.08 | Professional | 53 · Discontinued | $35.48 | $50.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $1,348.96 | Professional | 54 · Surgery only | $134.90 | $190.55 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.02 Typical High $275.42 | Professional | 55 · Aftercare only | $26.92 | $38.02 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $181.97 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $1,258.93 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $257.04 Typical High $398.11 | Professional | 51 · Multiple procedures | $181.97 | $257.04 | $398.11 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $416.87 Typical High $630.96 | Professional | 54 · Surgery only | $295.12 | $416.87 | $630.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $104.71 Typical High $158.49 | Professional | 55 · Aftercare only | $72.44 | $104.71 | $158.49 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $436.52 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $309.03 | $436.52 | $660.69 |
Where Wisconsin sits
The same service costs 3.9 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
$741
AK $851TX $219
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.