How much rates vary
Facilitymedian $2,818 · 10th to 90th $851 to $5,754Professionalmedian $2,570 · 10th to 90th $955 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 $724.44 Median $851.14 Typical High $14,454.40 | Facility | None | $724.44 | $851.14 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $5,754.40 | Professional | None | $724.44 | $851.14 | $5,754.40 |
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 $1,230.27 Median $2,951.21 Typical High $4,570.88 | Professional | None | $1,230.27 | $2,951.21 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,000.00 | $2,454.71 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $3,019.95 | Professional | None | $933.25 | $1,380.38 | $3,019.95 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $3,090.30 Typical High $5,370.32 | Facility | None | $933.25 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,479.11 | $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 $1,023.29 Median $3,235.94 Typical High $7,413.10 | Professional | None | $1,023.29 | $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 $1,380.38 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,380.38 | $2,290.87 | $2,818.38 |
Prevea360 Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,737.80 | Facility | None | $776.25 | $1,000.00 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,258.93 | $2,344.23 | $3,630.78 |
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 $870.96 Median $1,148.15 Typical High $2,187.76 | Professional | None | $870.96 | $1,148.15 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,715.35 Typical High $4,786.30 | Professional | None | $1,819.70 | $3,715.35 | $4,786.30 |
The Alliance Setting Professional Modifier None Typical Low $1,862.09 Median $3,630.78 Typical High $6,025.60 | Professional | None | $1,862.09 | $3,630.78 | $6,025.60 |
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 $912.01 Median $2,089.30 Typical High $3,890.45 | Professional | None | $912.01 | $2,089.30 | $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 $363.08 Median $363.08 Typical High $426.58 | Facility | 52 · Reduced service | $363.08 | $363.08 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $173.78 | Facility | 53 · Discontinued | $144.54 | $144.54 | $173.78 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $645.65 | Facility | 54 · Surgery only | $549.54 | $549.54 | $645.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $128.82 | Facility | 55 · Aftercare only | $109.65 | $109.65 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $85.11 | Facility | 56 · Pre-op care only | $72.44 | $72.44 | $85.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $602.56 | Facility | 78 · Unplanned return to OR | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $426.58 Typical High $3,162.28 | Professional | 52 · Reduced service | $363.08 | $426.58 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $1,288.25 | Professional | 53 · Discontinued | $144.54 | $173.78 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $4,786.30 | Professional | 54 · Surgery only | $549.54 | $645.65 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $954.99 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $645.65 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $4,466.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $891.25 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $741.31 | $891.25 | $1,348.96 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,412.54 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,202.26 | $1,412.54 | $2,137.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $354.81 Typical High $537.03 | Professional | 55 · Aftercare only | $295.12 | $354.81 | $537.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,479.11 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,479.11 | $2,238.72 |
Where Wisconsin sits
The same service costs 4.4 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
$2,630
AK $3,311TX $759
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.