How much rates vary
Facilitymedian $2,630 · 10th to 90th $288 to $5,623Professionalmedian $617 · 10th to 90th $263 to $1,259
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 $169.82 Median $263.03 Typical High $14,454.40 | Facility | None | $169.82 | $263.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $2,238.72 | Professional | None | $169.82 | $263.03 | $2,238.72 |
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 $302.00 Median $724.44 Typical High $1,288.25 | Professional | None | $302.00 | $724.44 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $467.74 Typical High $912.01 | Facility | None | $50.12 | $467.74 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $489.78 Typical High $870.96 | Professional | None | $251.19 | $489.78 | $870.96 |
DeanCare Setting Facility Modifier None Typical Low $263.03 Median $2,570.40 Typical High $4,786.30 | Facility | None | $263.03 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $776.25 | Professional | None | $331.13 | $512.86 | $776.25 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $2,187.76 Typical High $4,677.35 | Facility | None | $354.81 | $2,187.76 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $912.01 Typical High $2,137.96 | Professional | None | $295.12 | $912.01 | $2,137.96 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $794.33 | Professional | None | $407.38 | $537.03 | $794.33 |
Prevea360 Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $602.56 | Facility | None | $173.78 | $316.23 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $977.24 | Professional | None | $323.59 | $602.56 | $977.24 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $512.86 | Facility | None | $50.12 | $338.84 | $512.86 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $549.54 | Professional | None | $239.88 | $354.81 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | None | $346.74 | $346.74 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,445.44 | Professional | None | $426.58 | $912.01 | $1,445.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $223.87 Median $562.34 Typical High $1,096.48 | Professional | None | $223.87 | $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 $85.11 Median $85.11 Typical High $131.83 | Facility | 52 · Reduced service | $85.11 | $85.11 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $52.48 | Facility | 53 · Discontinued | $34.67 | $34.67 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $199.53 | Facility | 54 · Surgery only | $128.82 | $128.82 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $39.81 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $26.30 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $26.30 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $120.23 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $131.83 Typical High $1,122.02 | Professional | 52 · Reduced service | $85.11 | $131.83 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $52.48 Typical High $446.68 | Professional | 53 · Discontinued | $34.67 | $52.48 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $199.53 Typical High $1,698.24 | Professional | 54 · Surgery only | $128.82 | $199.53 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $39.81 Typical High $338.84 | Professional | 55 · Aftercare only | $25.70 | $39.81 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.30 Typical High $223.87 | Professional | 56 · Pre-op care only | $16.98 | $26.30 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $186.21 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $120.23 | $186.21 | $1,584.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $257.04 Typical High $389.05 | Professional | 51 · Multiple procedures | $165.96 | $257.04 | $389.05 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $407.38 Typical High $616.60 | Professional | 54 · Surgery only | $263.03 | $407.38 | $616.60 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $102.33 Typical High $154.88 | Professional | 55 · Aftercare only | $66.07 | $102.33 | $154.88 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $645.65 |
Where Wisconsin sits
The same service costs 3.5 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
$708
AK $759TX $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.