How much rates vary
Facilitymedian $1,380 · 10th to 90th $91 to $3,981Professionalmedian $219 · 10th to 90th $85 to $437
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 $61.66 Median $85.11 Typical High $14,454.40 | Facility | None | $61.66 | $85.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $575.44 | Professional | None | $61.66 | $85.11 | $575.44 |
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 $104.71 Median $269.15 Typical High $446.68 | Professional | None | $104.71 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $269.15 Typical High $416.87 | Facility | None | $50.12 | $269.15 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $302.00 | Professional | None | $81.28 | $125.89 | $302.00 |
DeanCare Setting Facility Modifier None Typical Low $79.43 Median $2,630.27 Typical High $5,128.61 | Facility | None | $79.43 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $269.15 | Professional | None | $125.89 | $177.83 | $269.15 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $912.01 Typical High $1,778.28 | Facility | None | $117.49 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $302.00 Typical High $741.31 | Professional | None | $100.00 | $302.00 | $741.31 |
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 $138.04 Median $199.53 Typical High $275.42 | Professional | None | $138.04 | $199.53 | $275.42 |
Prevea360 Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $186.21 | Facility | None | $63.10 | $91.20 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $323.59 | Professional | None | $107.15 | $204.17 | $323.59 |
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 $81.28 Median $114.82 Typical High $186.21 | Professional | None | $81.28 | $114.82 | $186.21 |
Security Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | None | $131.83 | $131.83 | $190.55 |
Security Health Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $478.63 | Professional | None | $162.18 | $338.84 | $478.63 |
The Alliance Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $602.56 | Professional | None | $181.97 | $354.81 | $602.56 |
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 $79.43 Median $194.98 Typical High $371.54 | Professional | None | $79.43 | $194.98 | $371.54 |
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 $42.66 | Facility | 52 · Reduced service | $30.20 | $30.20 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $16.98 | Facility | 53 · Discontinued | $12.30 | $12.30 | $16.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $64.57 | Facility | 54 · Surgery only | $45.71 | $45.71 | $64.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $12.88 | Facility | 55 · Aftercare only | $9.12 | $9.12 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $8.51 | Facility | 56 · Pre-op care only | $6.17 | $6.17 | $8.51 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $42.66 Typical High $60.26 | Facility | 78 · Unplanned return to OR | $42.66 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $42.66 Typical High $316.23 | Professional | 52 · Reduced service | $30.20 | $42.66 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.98 Typical High $125.89 | Professional | 53 · Discontinued | $12.30 | $16.98 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $64.57 Typical High $467.74 | Professional | 54 · Surgery only | $45.71 | $64.57 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.88 Typical High $93.33 | Professional | 55 · Aftercare only | $9.12 | $12.88 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.51 Typical High $63.10 | Professional | 56 · Pre-op care only | $6.17 | $8.51 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $60.26 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $42.66 | $60.26 | $436.52 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $63.10 Median $89.13 Typical High $134.90 | Professional | 51 · Multiple procedures | $63.10 | $89.13 | $134.90 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $213.80 | Professional | 54 · Surgery only | $100.00 | $141.25 | $213.80 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $35.48 Typical High $53.70 | Professional | 55 · Aftercare only | $25.12 | $35.48 | $53.70 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $147.91 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $104.71 | $147.91 | $223.87 |
Where Wisconsin sits
The same service costs 3.8 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
$257
AK $288KY $75.86
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.