How much rates vary
Facilitymedian $1,202 · 10th to 90th $234 to $3,802Professionalmedian $646 · 10th to 90th $269 to $1,318
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 $269.15 Typical High $14,454.40 | Facility | None | $169.82 | $269.15 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $1,318.26 | Professional | None | $169.82 | $269.15 | $1,318.26 |
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 $316.23 Median $758.58 Typical High $1,412.54 | Professional | None | $316.23 | $758.58 | $1,412.54 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $389.05 | Professional | None | $288.40 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $524.81 Typical High $977.24 | Facility | None | $50.12 | $524.81 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $524.81 Typical High $954.99 | Professional | None | $263.03 | $524.81 | $954.99 |
DeanCare Setting Facility Modifier None Typical Low $234.42 Median $2,570.40 Typical High $4,786.30 | Facility | None | $234.42 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $831.76 | Professional | None | $346.74 | $549.54 | $831.76 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $933.25 Typical High $2,344.23 | Professional | None | $309.03 | $933.25 | $2,344.23 |
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 $436.52 Median $602.56 Typical High $851.14 | Professional | None | $436.52 | $602.56 | $851.14 |
Prevea360 Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $645.65 | Facility | None | $181.97 | $302.00 | $645.65 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $630.96 Typical High $1,023.29 | Professional | None | $346.74 | $630.96 | $1,023.29 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $380.19 Typical High $575.44 | Facility | None | $50.12 | $380.19 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $588.84 | Professional | None | $263.03 | $380.19 | $588.84 |
Security Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $954.99 Typical High $1,548.82 | Professional | None | $446.68 | $954.99 | $1,548.82 |
The Alliance Setting Professional Modifier None Typical Low $389.05 Median $741.31 Typical High $1,348.96 | Professional | None | $389.05 | $741.31 | $1,348.96 |
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 $229.09 Median $588.84 Typical High $1,148.15 | Professional | None | $229.09 | $588.84 | $1,148.15 |
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 $134.90 | Facility | 52 · Reduced service | $85.11 | $85.11 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $53.70 | Facility | 53 · Discontinued | $33.88 | $33.88 | $53.70 |
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 $26.92 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $26.92 |
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 $134.90 Typical High $977.24 | Professional | 52 · Reduced service | $85.11 | $134.90 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $53.70 Typical High $389.05 | Professional | 53 · Discontinued | $33.88 | $53.70 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $199.53 Typical High $1,479.11 | Professional | 54 · Surgery only | $128.82 | $199.53 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $39.81 Typical High $295.12 | Professional | 55 · Aftercare only | $25.70 | $39.81 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.92 Typical High $194.98 | Professional | 56 · Pre-op care only | $16.98 | $26.92 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $186.21 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $120.23 | $186.21 | $1,380.38 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $275.42 Typical High $416.87 | Professional | 51 · Multiple procedures | $173.78 | $275.42 | $416.87 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $281.84 | $446.68 | $676.08 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $109.65 Typical High $165.96 | Professional | 55 · Aftercare only | $69.18 | $109.65 | $165.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $295.12 | $467.74 | $707.95 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$724
AK $813MD $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.