How much rates vary
Facilitymedian $1,259 · 10th to 90th $302 to $3,890Professionalmedian $813 · 10th to 90th $331 to $1,660
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 $204.17 Median $331.13 Typical High $14,454.40 | Facility | None | $204.17 | $331.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $1,348.96 | Professional | None | $204.17 | $331.13 | $1,348.96 |
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 $389.05 Median $912.01 Typical High $1,737.80 | Professional | None | $389.05 | $912.01 | $1,737.80 |
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 $346.74 Median $630.96 Typical High $1,174.90 | Professional | None | $346.74 | $630.96 | $1,174.90 |
DeanCare Setting Facility Modifier None Typical Low $295.12 Median $3,090.30 Typical High $5,370.32 | Facility | None | $295.12 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,023.29 | Professional | None | $416.87 | $676.08 | $1,023.29 |
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 $398.11 Median $1,230.27 Typical High $2,884.03 | Professional | None | $398.11 | $1,230.27 | $2,884.03 |
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 $537.03 Median $794.33 Typical High $1,071.52 | Professional | None | $537.03 | $794.33 | $1,071.52 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $588.84 | Facility | None | $218.78 | $371.54 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $776.25 Typical High $1,258.93 | Professional | None | $426.58 | $776.25 | $1,258.93 |
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 $338.84 Median $457.09 Typical High $724.44 | Professional | None | $338.84 | $457.09 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $741.31 | Professional | None | $446.68 | $446.68 | $741.31 |
Security Health Setting Professional Modifier None Typical Low $549.54 Median $1,148.15 Typical High $1,905.46 | Professional | None | $549.54 | $1,148.15 | $1,905.46 |
The Alliance Setting Professional Modifier None Typical Low $416.87 Median $977.24 Typical High $2,238.72 | Professional | None | $416.87 | $977.24 | $2,238.72 |
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 $288.40 Median $758.58 Typical High $1,479.11 | Professional | None | $288.40 | $758.58 | $1,479.11 |
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 $102.33 Median $102.33 Typical High $165.96 | Facility | 52 · Reduced service | $102.33 | $102.33 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $66.07 | Facility | 53 · Discontinued | $40.74 | $40.74 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $245.47 | Facility | 54 · Surgery only | $154.88 | $154.88 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $48.98 | Facility | 55 · Aftercare only | $30.90 | $30.90 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $33.11 | Facility | 56 · Pre-op care only | $20.42 | $20.42 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $144.54 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $165.96 Typical High $1,288.25 | Professional | 52 · Reduced service | $102.33 | $165.96 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $66.07 Typical High $512.86 | Professional | 53 · Discontinued | $40.74 | $66.07 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $245.47 Typical High $1,905.46 | Professional | 54 · Surgery only | $154.88 | $245.47 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $48.98 Typical High $389.05 | Professional | 55 · Aftercare only | $30.90 | $48.98 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $33.11 Typical High $257.04 | Professional | 56 · Pre-op care only | $20.42 | $33.11 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $229.09 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $144.54 | $229.09 | $1,778.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $338.84 Typical High $512.86 | Professional | 51 · Multiple procedures | $208.93 | $338.84 | $512.86 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $537.03 Typical High $831.76 | Professional | 54 · Surgery only | $338.84 | $537.03 | $831.76 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $204.17 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $204.17 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $354.81 | $575.44 | $870.96 |
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
$871
AK $977MD $282
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.