How much rates vary
Facilitymedian $3,020 · 10th to 90th $759 to $6,166Professionalmedian $1,995 · 10th to 90th $741 to $3,548
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 $549.54 Median $676.08 Typical High $14,454.40 | Facility | None | $549.54 | $676.08 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $5,888.44 | Professional | None | $549.54 | $676.08 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $2,344.23 Typical High $3,548.13 | Professional | None | $954.99 | $2,344.23 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,235.94 | Facility | None | $954.99 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,344.23 | Professional | None | $741.31 | $1,071.52 | $2,344.23 |
DeanCare Setting Facility Modifier None Typical Low $724.44 Median $4,168.69 Typical High $7,413.10 | Facility | None | $724.44 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,380.38 | $2,089.30 |
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 $851.14 Median $2,570.40 Typical High $5,888.44 | Professional | None | $851.14 | $2,570.40 | $5,888.44 |
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 $1,096.48 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,819.70 | $2,238.72 |
Prevea360 Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $1,318.26 | Facility | None | $602.56 | $870.96 | $1,318.26 |
Quartz Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $2,818.38 | Professional | None | $977.24 | $1,819.70 | $2,818.38 |
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 $741.31 Median $891.25 Typical High $1,621.81 | Professional | None | $741.31 | $891.25 | $1,621.81 |
Security Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,202.26 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $3,801.89 | Professional | None | $1,445.44 | $2,884.03 | $3,801.89 |
The Alliance Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,128.61 | Professional | None | $3,890.45 | $3,890.45 | $5,128.61 |
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 $724.44 Median $1,621.81 Typical High $3,090.30 | Professional | None | $724.44 | $1,621.81 | $3,090.30 |
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 $275.42 Median $275.42 Typical High $338.84 | Facility | 52 · Reduced service | $275.42 | $275.42 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $134.90 | Facility | 53 · Discontinued | $112.20 | $112.20 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $501.19 | Facility | 54 · Surgery only | $416.87 | $416.87 | $501.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $100.00 | Facility | 55 · Aftercare only | $83.18 | $83.18 | $100.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $67.61 | Facility | 56 · Pre-op care only | $54.95 | $54.95 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $467.74 | Facility | 78 · Unplanned return to OR | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $338.84 Typical High $3,235.94 | Professional | 52 · Reduced service | $275.42 | $338.84 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $1,318.26 | Professional | 53 · Discontinued | $112.20 | $134.90 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $4,897.79 | Professional | 54 · Surgery only | $416.87 | $501.19 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $977.24 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $645.65 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $4,570.88 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $691.83 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $575.44 | $691.83 | $1,047.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,096.48 Typical High $1,698.24 | Professional | 54 · Surgery only | $912.01 | $1,096.48 | $1,698.24 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $416.87 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $416.87 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,148.15 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $954.99 | $1,148.15 | $1,778.28 |
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
$2,138
AK $2,630TX $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.