How much rates vary
Facilitymedian $1,259 · 10th to 90th $302 to $3,890Professionalmedian $741 · 10th to 90th $316 to $1,585
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 $186.21 Median $323.59 Typical High $14,454.40 | Facility | None | $186.21 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $2,884.03 | Professional | None | $186.21 | $323.59 | $2,884.03 |
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 $371.54 Median $851.14 Typical High $1,659.59 | Professional | None | $371.54 | $851.14 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,380.38 | Facility | None | $371.54 | $724.44 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $1,148.15 | Professional | None | $309.03 | $602.56 | $1,148.15 |
DeanCare Setting Facility Modifier None Typical Low $281.84 Median $3,090.30 Typical High $5,370.32 | Facility | None | $281.84 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $1,000.00 | Professional | None | $380.19 | $660.69 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $954.99 Typical High $2,089.30 | Facility | None | $234.42 | $954.99 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $1,148.15 Typical High $2,818.38 | Professional | None | $380.19 | $1,148.15 | $2,818.38 |
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 $478.63 Median $660.69 Typical High $1,000.00 | Professional | None | $478.63 | $660.69 | $1,000.00 |
Prevea360 Setting Facility Modifier None Typical Low $199.53 Median $380.19 Typical High $691.83 | Facility | None | $199.53 | $380.19 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $758.58 Typical High $1,288.25 | Professional | None | $426.58 | $758.58 | $1,288.25 |
Quartz Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,122.02 | Facility | None | $363.08 | $562.34 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $707.95 | Professional | None | $309.03 | $426.58 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $724.44 | Professional | None | $398.11 | $398.11 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $1,023.29 Typical High $1,862.09 | Professional | None | $478.63 | $1,023.29 | $1,862.09 |
The Alliance Setting Professional Modifier None Typical Low $354.81 Median $794.33 Typical High $1,479.11 | Professional | None | $354.81 | $794.33 | $1,479.11 |
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 $251.19 Median $660.69 Typical High $1,380.38 | Professional | None | $251.19 | $660.69 | $1,380.38 |
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 $93.33 Median $93.33 Typical High $162.18 | Facility | 52 · Reduced service | $93.33 | $93.33 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $64.57 | Facility | 53 · Discontinued | $37.15 | $37.15 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $239.88 | Facility | 54 · Surgery only | $138.04 | $138.04 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $48.98 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $32.36 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $128.82 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $162.18 Typical High $1,445.44 | Professional | 52 · Reduced service | $93.33 | $162.18 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $64.57 Typical High $575.44 | Professional | 53 · Discontinued | $37.15 | $64.57 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $239.88 Typical High $2,137.96 | Professional | 54 · Surgery only | $138.04 | $239.88 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $48.98 Typical High $426.58 | Professional | 55 · Aftercare only | $28.18 | $48.98 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $32.36 Typical High $288.40 | Professional | 56 · Pre-op care only | $18.62 | $32.36 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $223.87 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $128.82 | $223.87 | $1,995.26 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $331.13 Typical High $501.19 | Professional | 51 · Multiple procedures | $190.55 | $331.13 | $501.19 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $537.03 Typical High $812.83 | Professional | 54 · Surgery only | $302.00 | $537.03 | $812.83 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $131.83 Typical High $204.17 | Professional | 55 · Aftercare only | $75.86 | $131.83 | $204.17 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $562.34 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $323.59 | $562.34 | $851.14 |
Where Wisconsin sits
The same service costs 3.5 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
$832
AK $891MD $257
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.