How much rates vary
Facilitymedian $2,818 · 10th to 90th $708 to $5,888Professionalmedian $1,698 · 10th to 90th $646 to $3,020
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 $489.78 Median $602.56 Typical High $14,454.40 | Facility | None | $489.78 | $602.56 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $4,265.80 | Professional | None | $489.78 | $602.56 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $2,041.74 Typical High $3,162.28 | Professional | None | $831.76 | $2,041.74 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $3,162.28 | Facility | None | $954.99 | $2,089.30 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $2,089.30 | Professional | None | $630.96 | $933.25 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $645.65 Median $4,168.69 Typical High $7,413.10 | Facility | None | $645.65 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,230.27 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,344.23 Typical High $5,623.41 | Facility | None | $645.65 | $2,344.23 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $2,187.76 Typical High $5,248.07 | Professional | None | $724.44 | $2,187.76 | $5,248.07 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,949.84 | Professional | None | $954.99 | $1,584.89 | $1,949.84 |
Prevea360 Setting Facility Modifier None Typical Low $524.81 Median $776.25 Typical High $1,174.90 | Facility | None | $524.81 | $776.25 | $1,174.90 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,454.71 | Professional | None | $891.25 | $1,621.81 | $2,454.71 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $3,235.94 | Facility | None | $758.58 | $2,041.74 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,380.38 | Professional | None | $630.96 | $812.83 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,047.13 | $1,318.26 |
Security Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,230.27 | $2,511.89 | $3,388.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,412.54 Typical High $2,691.53 | Professional | None | $630.96 | $1,412.54 | $2,691.53 |
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 $245.47 Median $245.47 Typical High $302.00 | Facility | 52 · Reduced service | $245.47 | $245.47 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $120.23 | Facility | 53 · Discontinued | $97.72 | $97.72 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $457.09 | Facility | 54 · Surgery only | $363.08 | $363.08 | $457.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $91.20 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $60.26 | Facility | 56 · Pre-op care only | $48.98 | $48.98 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $338.84 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $302.00 Typical High $2,344.23 | Professional | 52 · Reduced service | $245.47 | $302.00 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $933.25 | Professional | 53 · Discontinued | $97.72 | $120.23 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $457.09 Typical High $3,467.37 | Professional | 54 · Surgery only | $363.08 | $457.09 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $691.83 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $467.74 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $426.58 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $338.84 | $426.58 | $3,235.94 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $616.60 Typical High $933.25 | Professional | 51 · Multiple procedures | $501.19 | $616.60 | $933.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,000.00 Typical High $1,513.56 | Professional | 54 · Surgery only | $794.33 | $1,000.00 | $1,513.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $245.47 Typical High $380.19 | Professional | 55 · Aftercare only | $199.53 | $245.47 | $380.19 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,047.13 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $831.76 | $1,047.13 | $1,584.89 |
Where Wisconsin sits
The same service costs 4.3 times more in Alaska than in Texas. 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
$1,905
AK $2,291TX $537
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.