How much rates vary
Facilitymedian $2,818 · 10th to 90th $708 to $5,754Professionalmedian $1,862 · 10th to 90th $692 to $3,311
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 $524.81 Median $660.69 Typical High $14,454.40 | Facility | None | $524.81 | $660.69 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $5,011.87 | Professional | None | $524.81 | $660.69 | $5,011.87 |
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 $891.25 Median $2,187.76 Typical High $3,467.37 | Professional | None | $891.25 | $2,187.76 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $3,162.28 | Facility | None | $1,000.00 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $2,290.87 | Professional | None | $691.83 | $1,000.00 | $2,290.87 |
DeanCare Setting Facility Modifier None Typical Low $676.08 Median $3,090.30 Typical High $5,370.32 | Facility | None | $676.08 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,348.96 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $2,187.76 Typical High $5,623.41 | Facility | None | $660.69 | $2,187.76 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $2,454.71 Typical High $5,754.40 | Professional | None | $812.83 | $2,454.71 | $5,754.40 |
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 $1,047.13 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,737.80 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $562.34 Median $812.83 Typical High $1,230.27 | Facility | None | $562.34 | $812.83 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $1,737.80 Typical High $2,630.27 | Professional | None | $933.25 | $1,737.80 | $2,630.27 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,041.74 Typical High $3,090.30 | Facility | None | $724.44 | $2,041.74 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,698.24 | Professional | None | $691.83 | $870.96 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,715.35 | Professional | None | $1,318.26 | $2,754.23 | $3,715.35 |
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 $660.69 Median $1,548.82 Typical High $2,951.21 | Professional | None | $660.69 | $1,548.82 | $2,951.21 |
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 $257.04 Median $257.04 Typical High $331.13 | Facility | 52 · Reduced service | $257.04 | $257.04 | $331.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $131.83 | Facility | 53 · Discontinued | $104.71 | $104.71 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $489.78 | Facility | 54 · Surgery only | $389.05 | $389.05 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $97.72 | Facility | 55 · Aftercare only | $77.62 | $77.62 | $97.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $66.07 | Facility | 56 · Pre-op care only | $52.48 | $52.48 | $66.07 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $363.08 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $331.13 Typical High $2,754.23 | Professional | 52 · Reduced service | $257.04 | $331.13 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $1,096.48 | Professional | 53 · Discontinued | $104.71 | $131.83 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $4,073.80 | Professional | 54 · Surgery only | $389.05 | $489.78 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $812.83 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $549.54 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $457.09 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $363.08 | $457.09 | $3,801.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $676.08 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $537.03 | $676.08 | $1,023.29 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,071.52 Typical High $1,659.59 | Professional | 54 · Surgery only | $851.14 | $1,071.52 | $1,659.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $269.15 Typical High $407.38 | Professional | 55 · Aftercare only | $213.80 | $269.15 | $407.38 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $891.25 | $1,148.15 | $1,737.80 |
Where Wisconsin sits
The same service costs 4.2 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
$2,042
AK $2,455TX $589
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.