How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,072 to $9,120Professionalmedian $2,512 · 10th to 90th $891 to $4,266
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 $794.33 Median $6,456.54 Typical High $14,454.40 | Facility | None | $794.33 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $11,481.54 | Professional | None | $794.33 | $794.33 | $11,481.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $2,818.38 Typical High $4,365.16 | Professional | None | $1,071.52 | $2,818.38 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,454.71 Typical High $3,630.78 | Facility | None | $954.99 | $2,454.71 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $5,128.61 | Professional | None | $977.24 | $1,659.59 | $5,128.61 |
DeanCare Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $5,888.44 | Facility | None | $1,023.29 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,659.59 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,630.78 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $2,511.89 Typical High $6,918.31 | Professional | None | $977.24 | $2,511.89 | $6,918.31 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,258.93 | $2,041.74 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,862.09 | Facility | None | $812.83 | $1,023.29 | $1,862.09 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,981.07 | Professional | None | $933.25 | $1,995.26 | $3,981.07 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,290.87 Typical High $3,467.37 | Facility | None | $758.58 | $2,290.87 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $2,238.72 | Professional | None | $912.01 | $1,047.13 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $3,890.45 Typical High $4,570.88 | Professional | None | $1,659.59 | $3,890.45 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,862.09 Typical High $3,801.89 | Professional | None | $851.14 | $1,862.09 | $3,801.89 |
6 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 Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $5,754.40 | Professional | 52 · Reduced service | $389.05 | $389.05 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $2,290.87 | Professional | 53 · Discontinued | $158.49 | $158.49 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $8,709.64 | Professional | 54 · Surgery only | $588.84 | $588.84 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $1,737.80 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $8,128.31 |
Where Wisconsin sits
The same service costs 7.1 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
$2,818
AK $3,802TX $537
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.