How much rates vary
Facilitymedian $2,818 · 10th to 90th $851 to $5,888Professionalmedian $2,512 · 10th to 90th $933 to $4,467
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 $691.83 Median $851.14 Typical High $14,454.40 | Facility | None | $691.83 | $851.14 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $6,760.83 | Professional | None | $691.83 | $851.14 | $6,760.83 |
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 $1,202.26 Median $2,951.21 Typical High $4,466.84 | Professional | None | $1,202.26 | $2,951.21 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,691.53 Typical High $3,467.37 | Facility | None | $954.99 | $2,691.53 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $3,235.94 | Professional | None | $933.25 | $1,348.96 | $3,235.94 |
DeanCare Setting Facility Modifier None Typical Low $912.01 Median $4,168.69 Typical High $7,413.10 | Facility | None | $912.01 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,778.28 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,344.23 Typical High $5,623.41 | Facility | None | $707.95 | $2,344.23 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $7,413.10 | Professional | None | $1,071.52 | $3,235.94 | $7,413.10 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,348.96 | $2,290.87 | $2,818.38 |
Prevea360 Setting Facility Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,659.59 | Facility | None | $758.58 | $1,096.48 | $1,659.59 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,230.27 | $2,290.87 | $3,548.13 |
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 $933.25 Median $1,148.15 Typical High $2,290.87 | Professional | None | $933.25 | $1,148.15 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,513.56 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,630.78 Typical High $4,786.30 | Professional | None | $1,819.70 | $3,630.78 | $4,786.30 |
The Alliance Setting Professional Modifier None Typical Low $1,412.54 Median $3,162.28 Typical High $5,888.44 | Professional | None | $1,412.54 | $3,162.28 | $5,888.44 |
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 $933.25 Median $2,041.74 Typical High $3,890.45 | Professional | None | $933.25 | $2,041.74 | $3,890.45 |
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 $346.74 Median $346.74 Typical High $426.58 | Facility | 52 · Reduced service | $346.74 | $346.74 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | 53 · Discontinued | $141.25 | $141.25 | $169.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $645.65 | Facility | 54 · Surgery only | $524.81 | $524.81 | $645.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $128.82 | Facility | 55 · Aftercare only | $104.71 | $104.71 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $85.11 | Facility | 56 · Pre-op care only | $69.18 | $69.18 | $85.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $602.56 | Facility | 78 · Unplanned return to OR | $489.78 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $426.58 Typical High $3,715.35 | Professional | 52 · Reduced service | $346.74 | $426.58 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $1,513.56 | Professional | 53 · Discontinued | $141.25 | $169.82 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $5,623.41 | Professional | 54 · Surgery only | $524.81 | $645.65 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $1,122.02 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $758.58 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $5,248.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $870.96 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $724.44 | $870.96 | $1,348.96 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,412.54 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,148.15 | $1,412.54 | $2,137.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $354.81 Typical High $537.03 | Professional | 55 · Aftercare only | $288.40 | $354.81 | $537.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,479.11 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,479.11 | $2,238.72 |
Where Wisconsin sits
The same service costs 4.5 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
$2,570
AK $3,311TX $741
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.