How much rates vary
Facilitymedian $1,288 · 10th to 90th $309 to $4,467Professionalmedian $832 · 10th to 90th $339 to $1,698
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 $208.93 Median $338.84 Typical High $14,454.40 | Facility | None | $208.93 | $338.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $1,445.44 | Professional | None | $208.93 | $338.84 | $1,445.44 |
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 $398.11 Median $954.99 Typical High $1,778.28 | Professional | None | $398.11 | $954.99 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $489.78 | Professional | None | $363.08 | $389.05 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,584.89 | Facility | None | $660.69 | $1,047.13 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,202.26 | Professional | None | $346.74 | $645.65 | $1,202.26 |
DeanCare Setting Facility Modifier None Typical Low $288.40 Median $4,168.69 Typical High $7,413.10 | Facility | None | $288.40 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $1,047.13 | Professional | None | $426.58 | $691.83 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,000.00 Typical High $2,089.30 | Facility | None | $234.42 | $1,000.00 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,258.93 Typical High $2,951.21 | Professional | None | $407.38 | $1,258.93 | $2,951.21 |
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 $562.34 Median $812.83 Typical High $1,122.02 | Professional | None | $562.34 | $812.83 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $602.56 | Facility | None | $223.87 | $371.54 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $1,288.25 | Professional | None | $436.52 | $776.25 | $1,288.25 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,288.25 | Facility | None | $645.65 | $831.76 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $741.31 | Professional | None | $346.74 | $467.74 | $741.31 |
Security Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $758.58 | Professional | None | $457.09 | $457.09 | $758.58 |
Security Health Setting Professional Modifier None Typical Low $549.54 Median $1,202.26 Typical High $1,949.84 | Professional | None | $549.54 | $1,202.26 | $1,949.84 |
The Alliance Setting Professional Modifier None Typical Low $724.44 Median $1,412.54 Typical High $2,454.71 | Professional | None | $724.44 | $1,412.54 | $2,454.71 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $295.12 Median $758.58 Typical High $1,548.82 | Professional | None | $295.12 | $758.58 | $1,548.82 |
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 $104.71 Median $104.71 Typical High $169.82 | Facility | 52 · Reduced service | $104.71 | $104.71 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $67.61 | Facility | 53 · Discontinued | $41.69 | $41.69 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $251.19 | Facility | 54 · Surgery only | $158.49 | $158.49 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $50.12 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $33.88 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $169.82 Typical High $1,174.90 | Professional | 52 · Reduced service | $104.71 | $169.82 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $67.61 Typical High $467.74 | Professional | 53 · Discontinued | $41.69 | $67.61 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $251.19 Typical High $1,778.28 | Professional | 54 · Surgery only | $158.49 | $251.19 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $50.12 Typical High $354.81 | Professional | 55 · Aftercare only | $31.62 | $50.12 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.88 Typical High $234.42 | Professional | 56 · Pre-op care only | $20.89 | $33.88 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $234.42 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $147.91 | $234.42 | $1,659.59 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $346.74 Typical High $524.81 | Professional | 51 · Multiple procedures | $213.80 | $346.74 | $524.81 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $549.54 Typical High $831.76 | Professional | 54 · Surgery only | $346.74 | $549.54 | $831.76 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $138.04 Typical High $208.93 | Professional | 55 · Aftercare only | $85.11 | $138.04 | $208.93 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $575.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $363.08 | $575.44 | $891.25 |
Where Wisconsin sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$912
AK $1,000UT $302
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.