How much rates vary
Facilitymedian $1,380 · 10th to 90th $74 to $3,890Professionalmedian $151 · 10th to 90th $60 to $282
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 $47.86 Median $58.88 Typical High $14,454.40 | Facility | None | $47.86 | $58.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $309.03 | Professional | None | $47.86 | $58.88 | $309.03 |
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 $64.57 Median $165.96 Typical High $269.15 | Professional | None | $64.57 | $165.96 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $85.11 | Professional | None | $63.10 | $67.61 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $186.21 Typical High $281.84 | Facility | None | $50.12 | $186.21 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $213.80 | Professional | None | $63.10 | $102.33 | $213.80 |
DeanCare Setting Facility Modifier None Typical Low $61.66 Median $2,630.27 Typical High $5,128.61 | Facility | None | $61.66 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $186.21 | Professional | None | $97.72 | $120.23 | $186.21 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $912.01 Typical High $1,778.28 | Facility | None | $81.28 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $416.87 | Professional | None | $74.13 | $213.80 | $416.87 |
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 $91.20 Median $154.88 Typical High $199.53 | Professional | None | $91.20 | $154.88 | $199.53 |
Prevea360 Setting Facility Modifier None Typical Low $51.29 Median $75.86 Typical High $125.89 | Facility | None | $51.29 | $75.86 | $125.89 |
Quartz Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $239.88 | Professional | None | $83.18 | $151.36 | $239.88 |
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 $63.10 Median $77.62 Typical High $158.49 | Professional | None | $63.10 | $77.62 | $158.49 |
Security Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | None | $102.33 | $102.33 | $125.89 |
Security Health Setting Professional Modifier None Typical Low $120.23 Median $257.04 Typical High $323.59 | Professional | None | $120.23 | $257.04 | $323.59 |
The Alliance Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $407.38 | Professional | None | $112.20 | $229.09 | $407.38 |
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 $57.54 Median $134.90 Typical High $257.04 | Professional | None | $57.54 | $134.90 | $257.04 |
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 $23.99 Median $23.99 Typical High $29.51 | Facility | 52 · Reduced service | $23.99 | $23.99 | $29.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $11.75 | Facility | 53 · Discontinued | $9.55 | $9.55 | $11.75 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $43.65 | Facility | 54 · Surgery only | $35.48 | $35.48 | $43.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $8.91 | Facility | 55 · Aftercare only | $7.08 | $7.08 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.89 | Facility | 56 · Pre-op care only | $4.79 | $4.79 | $5.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $33.11 Typical High $40.74 | Facility | 78 · Unplanned return to OR | $33.11 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $29.51 Typical High $229.09 | Professional | 52 · Reduced service | $23.99 | $29.51 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.75 Typical High $91.20 | Professional | 53 · Discontinued | $9.55 | $11.75 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $43.65 Typical High $338.84 | Professional | 54 · Surgery only | $35.48 | $43.65 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.91 Typical High $69.18 | Professional | 55 · Aftercare only | $7.08 | $8.91 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.89 Typical High $45.71 | Professional | 56 · Pre-op care only | $4.79 | $5.89 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $40.74 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $33.11 | $40.74 | $316.23 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $60.26 Typical High $91.20 | Professional | 51 · Multiple procedures | $48.98 | $60.26 | $91.20 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $147.91 | Professional | 54 · Surgery only | $77.62 | $97.72 | $147.91 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $24.55 Typical High $37.15 | Professional | 55 · Aftercare only | $19.50 | $24.55 | $37.15 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $102.33 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $81.28 | $102.33 | $154.88 |
Where Wisconsin sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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
$174
AK $224KY $53.70
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.