How much rates vary
Facilitymedian $1,202 · 10th to 90th $204 to $3,802Professionalmedian $562 · 10th to 90th $240 to $1,175
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 $239.88 Typical High $14,454.40 | Facility | None | $144.54 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $1,288.25 | Professional | None | $144.54 | $239.88 | $1,288.25 |
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 $275.42 Median $660.69 Typical High $1,258.93 | Professional | None | $275.42 | $660.69 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $346.74 | Professional | None | $257.04 | $275.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $501.19 Typical High $891.25 | Facility | None | $50.12 | $501.19 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $851.14 | Professional | None | $234.42 | $457.09 | $851.14 |
DeanCare Setting Facility Modifier None Typical Low $190.55 Median $2,570.40 Typical High $4,786.30 | Facility | None | $190.55 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $758.58 | Professional | None | $295.12 | $489.78 | $758.58 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $912.01 Typical High $1,778.28 | Facility | None | $186.21 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $831.76 Typical High $2,089.30 | Professional | None | $281.84 | $831.76 | $2,089.30 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $741.31 | Professional | None | $380.19 | $501.19 | $741.31 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $257.04 Typical High $588.84 | Facility | None | $141.25 | $257.04 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $933.25 | Professional | None | $316.23 | $549.54 | $933.25 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $363.08 Typical High $549.54 | Facility | None | $50.12 | $363.08 | $549.54 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $537.03 | Professional | None | $229.09 | $316.23 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $537.03 | Professional | None | $309.03 | $309.03 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $371.54 Median $794.33 Typical High $1,380.38 | Professional | None | $371.54 | $794.33 | $1,380.38 |
The Alliance Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $1,380.38 | Professional | None | $478.63 | $831.76 | $1,380.38 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $194.98 Median $501.19 Typical High $1,000.00 | Professional | None | $194.98 | $501.19 | $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 $120.23 | Facility | 52 · Reduced service | $72.44 | $72.44 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $47.86 | Facility | 53 · Discontinued | $28.84 | $28.84 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $181.97 | Facility | 54 · Surgery only | $107.15 | $107.15 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $36.31 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $23.99 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $100.00 | $100.00 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $120.23 Typical High $851.14 | Professional | 52 · Reduced service | $72.44 | $120.23 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $47.86 Typical High $338.84 | Professional | 53 · Discontinued | $28.84 | $47.86 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $181.97 Typical High $1,258.93 | Professional | 54 · Surgery only | $107.15 | $181.97 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $36.31 Typical High $251.19 | Professional | 55 · Aftercare only | $21.88 | $36.31 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.99 Typical High $169.82 | Professional | 56 · Pre-op care only | $14.45 | $23.99 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $169.82 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $100.00 | $169.82 | $1,174.90 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $245.47 Typical High $371.54 | Professional | 51 · Multiple procedures | $147.91 | $245.47 | $371.54 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $398.11 Typical High $602.56 | Professional | 54 · Surgery only | $234.42 | $398.11 | $602.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $100.00 Typical High $151.36 | Professional | 55 · Aftercare only | $58.88 | $100.00 | $151.36 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $416.87 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $251.19 | $416.87 | $630.96 |
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.