How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,072 to $9,120Professionalmedian $2,512 · 10th to 90th $871 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 $10,000.00 | Professional | None | $794.33 | $794.33 | $10,000.00 |
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 $2,754.23 Typical High $4,265.80 | Professional | None | $1,071.52 | $2,754.23 | $4,265.80 |
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 $1,000.00 Median $1,698.24 Typical High $5,128.61 | Professional | None | $1,000.00 | $1,698.24 | $5,128.61 |
DeanCare Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,023.29 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,659.59 | $1,698.24 | $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 $954.99 Median $2,454.71 Typical High $6,760.83 | Professional | None | $954.99 | $2,454.71 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $1,819.70 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,819.70 | $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 $1,819.70 | Facility | None | $812.83 | $1,023.29 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $2,041.74 Typical High $3,890.45 | Professional | None | $954.99 | $2,041.74 | $3,890.45 |
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 $954.99 Median $1,071.52 Typical High $2,187.76 | Professional | None | $954.99 | $1,071.52 | $2,187.76 |
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 $1,621.81 Median $3,890.45 Typical High $4,570.88 | Professional | None | $1,621.81 | $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 $870.96 Median $1,862.09 Typical High $3,715.35 | Professional | None | $870.96 | $1,862.09 | $3,715.35 |
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 $398.11 Median $398.11 Typical High $4,897.79 | Professional | 52 · Reduced service | $398.11 | $398.11 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $1,995.26 | Professional | 53 · Discontinued | $158.49 | $158.49 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $7,413.10 | Professional | 54 · Surgery only | $602.56 | $602.56 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $1,479.11 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $6,918.31 |
Where Wisconsin sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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.
Physician feeFacility fee
WI $7,760MD $2,243
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.