How much rates vary
Facilitymedian $1,380 · 10th to 90th $234 to $4,074Professionalmedian $794 · 10th to 90th $302 to $1,778
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 $186.21 Median $331.13 Typical High $14,454.40 | Facility | None | $186.21 | $331.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $2,238.72 | Professional | None | $186.21 | $331.13 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $851.14 Typical High $1,778.28 | Professional | None | $407.38 | $851.14 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,047.13 Typical High $1,621.81 | Facility | None | $50.12 | $1,047.13 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $1,174.90 | Professional | None | $251.19 | $467.74 | $1,174.90 |
DeanCare Setting Facility Modifier None Typical Low $245.47 Median $2,630.27 Typical High $5,128.61 | Facility | None | $245.47 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,047.13 | Professional | None | $389.05 | $691.83 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $1,412.54 Typical High $3,981.07 | Professional | None | $446.68 | $1,412.54 | $3,981.07 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,288.25 | Professional | None | $501.19 | $724.44 | $1,288.25 |
Prevea360 Setting Facility Modifier None Typical Low $181.97 Median $331.13 Typical High $812.83 | Facility | None | $181.97 | $331.13 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $758.58 Typical High $1,318.26 | Professional | None | $426.58 | $758.58 | $1,318.26 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $691.83 | Professional | None | $251.19 | $398.11 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $741.31 | Professional | None | $398.11 | $398.11 | $741.31 |
Security Health Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $2,041.74 | Professional | None | $562.34 | $1,047.13 | $2,041.74 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $263.03 Median $724.44 Typical High $1,778.28 | Professional | None | $263.03 | $724.44 | $1,778.28 |
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 $93.33 Median $93.33 Typical High $165.96 | Facility | 52 · Reduced service | $93.33 | $93.33 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $66.07 | Facility | 53 · Discontinued | $38.02 | $38.02 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $251.19 | Facility | 54 · Surgery only | $141.25 | $141.25 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $50.12 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $33.11 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $131.83 | $131.83 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $165.96 Typical High $1,122.02 | Professional | 52 · Reduced service | $93.33 | $165.96 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $66.07 Typical High $446.68 | Professional | 53 · Discontinued | $38.02 | $66.07 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $251.19 Typical High $1,659.59 | Professional | 54 · Surgery only | $141.25 | $251.19 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $50.12 Typical High $331.13 | Professional | 55 · Aftercare only | $28.18 | $50.12 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $33.11 Typical High $223.87 | Professional | 56 · Pre-op care only | $18.62 | $33.11 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $234.42 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $131.83 | $234.42 | $1,548.82 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $338.84 Typical High $524.81 | Professional | 51 · Multiple procedures | $194.98 | $338.84 | $524.81 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $549.54 Typical High $831.76 | Professional | 54 · Surgery only | $309.03 | $549.54 | $831.76 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $138.04 Typical High $208.93 | Professional | 55 · Aftercare only | $77.62 | $138.04 | $208.93 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $575.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $323.59 | $575.44 | $870.96 |
Where Wisconsin sits
The same service costs 4.6 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
$851
AK $1,000TX $219
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.