How much rates vary
Facilitymedian $1,380 · 10th to 90th $102 to $3,981Professionalmedian $204 · 10th to 90th $81 to $457
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 $60.26 Median $97.72 Typical High $14,454.40 | Facility | None | $60.26 | $97.72 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $346.74 | Professional | None | $60.26 | $97.72 | $346.74 |
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 $95.50 Median $218.78 Typical High $436.52 | Professional | None | $95.50 | $218.78 | $436.52 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $138.04 | Professional | None | $104.71 | $112.20 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $309.03 Typical High $478.63 | Facility | None | $50.12 | $309.03 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $346.74 | Professional | None | $79.43 | $147.91 | $346.74 |
DeanCare Setting Facility Modifier None Typical Low $77.62 Median $2,630.27 Typical High $5,128.61 | Facility | None | $77.62 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $309.03 | Professional | None | $123.03 | $199.53 | $309.03 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $2,041.74 | Facility | None | $128.82 | $912.01 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $363.08 Typical High $575.44 | Professional | None | $114.82 | $363.08 | $575.44 |
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 $147.91 Median $204.17 Typical High $309.03 | Professional | None | $147.91 | $204.17 | $309.03 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $208.93 | Facility | None | $64.57 | $104.71 | $208.93 |
Quartz Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $371.54 | Professional | None | $123.03 | $218.78 | $371.54 |
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 $79.43 Median $128.82 Typical High $218.78 | Professional | None | $79.43 | $128.82 | $218.78 |
Security Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $213.80 | Professional | None | $123.03 | $123.03 | $213.80 |
Security Health Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $549.54 | Professional | None | $151.36 | $316.23 | $549.54 |
The Alliance Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $524.81 | Professional | None | $131.83 | $263.03 | $524.81 |
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 $75.86 Median $204.17 Typical High $436.52 | Professional | None | $75.86 | $204.17 | $436.52 |
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 $30.20 Median $30.20 Typical High $48.98 | Facility | 52 · Reduced service | $30.20 | $30.20 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $19.50 | Facility | 53 · Discontinued | $12.02 | $12.02 | $19.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $72.44 | Facility | 54 · Surgery only | $44.67 | $44.67 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $14.79 | Facility | 55 · Aftercare only | $8.91 | $8.91 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $9.77 | Facility | 56 · Pre-op care only | $6.03 | $6.03 | $9.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $41.69 Typical High $67.61 | Facility | 78 · Unplanned return to OR | $41.69 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $48.98 Typical High $229.09 | Professional | 52 · Reduced service | $30.20 | $48.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $19.50 Typical High $91.20 | Professional | 53 · Discontinued | $12.02 | $19.50 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $72.44 Typical High $338.84 | Professional | 54 · Surgery only | $44.67 | $72.44 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $14.79 Typical High $67.61 | Professional | 55 · Aftercare only | $8.91 | $14.79 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.77 Typical High $45.71 | Professional | 56 · Pre-op care only | $6.03 | $9.77 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $67.61 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $41.69 | $67.61 | $316.23 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $100.00 Typical High $151.36 | Professional | 51 · Multiple procedures | $61.66 | $100.00 | $151.36 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $162.18 Typical High $245.47 | Professional | 54 · Surgery only | $97.72 | $162.18 | $245.47 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $40.74 Typical High $61.66 | Professional | 55 · Aftercare only | $24.55 | $40.74 | $61.66 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $169.82 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $102.33 | $169.82 | $257.04 |
Where Wisconsin sits
The same service costs 3.9 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
$234
AK $309KY $79.43
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.