How much rates vary
Facilitymedian $1,380 · 10th to 90th $166 to $3,981Professionalmedian $398 · 10th to 90th $166 to $832
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 $104.71 Median $165.96 Typical High $14,454.40 | Facility | None | $104.71 | $165.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $1,047.13 | Professional | None | $104.71 | $165.96 | $1,047.13 |
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 $194.98 Median $467.74 Typical High $870.96 | Professional | None | $194.98 | $467.74 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $524.81 Typical High $794.33 | Facility | None | $50.12 | $524.81 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $588.84 | Professional | None | $141.25 | $245.47 | $588.84 |
DeanCare Setting Facility Modifier None Typical Low $134.90 Median $2,630.27 Typical High $5,128.61 | Facility | None | $134.90 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $512.86 | Professional | None | $213.80 | $338.84 | $512.86 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $1,778.28 | Facility | None | $154.88 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $616.60 Typical High $1,445.44 | Professional | None | $194.98 | $616.60 | $1,445.44 |
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 $269.15 Median $371.54 Typical High $549.54 | Professional | None | $269.15 | $371.54 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $177.83 Typical High $371.54 | Facility | None | $112.20 | $177.83 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $616.60 | Professional | None | $208.93 | $380.19 | $616.60 |
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 $141.25 Median $218.78 Typical High $346.74 | Professional | None | $141.25 | $218.78 | $346.74 |
Security Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $363.08 | Professional | None | $223.87 | $223.87 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $933.25 | Professional | None | $295.12 | $588.84 | $933.25 |
The Alliance Setting Professional Modifier None Typical Low $208.93 Median $446.68 Typical High $1,023.29 | Professional | None | $208.93 | $446.68 | $1,023.29 |
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 $144.54 Median $371.54 Typical High $741.31 | Professional | None | $144.54 | $371.54 | $741.31 |
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 $52.48 Median $52.48 Typical High $83.18 | Facility | 52 · Reduced service | $52.48 | $52.48 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $33.11 | Facility | 53 · Discontinued | $20.89 | $20.89 | $33.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $125.89 | Facility | 54 · Surgery only | $79.43 | $79.43 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $25.12 | Facility | 55 · Aftercare only | $15.85 | $15.85 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $16.60 | Facility | 56 · Pre-op care only | $10.47 | $10.47 | $16.60 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $117.49 | Facility | 78 · Unplanned return to OR | $74.13 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $83.18 Typical High $575.44 | Professional | 52 · Reduced service | $52.48 | $83.18 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.11 Typical High $229.09 | Professional | 53 · Discontinued | $20.89 | $33.11 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $870.96 | Professional | 54 · Surgery only | $79.43 | $125.89 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $173.78 | Professional | 55 · Aftercare only | $15.85 | $25.12 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.60 Typical High $114.82 | Professional | 56 · Pre-op care only | $10.47 | $16.60 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $117.49 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $74.13 | $117.49 | $812.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $169.82 Typical High $257.04 | Professional | 51 · Multiple procedures | $107.15 | $169.82 | $257.04 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $275.42 Typical High $416.87 | Professional | 54 · Surgery only | $173.78 | $275.42 | $416.87 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $67.61 Typical High $104.71 | Professional | 55 · Aftercare only | $43.65 | $67.61 | $104.71 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $288.40 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $181.97 | $288.40 | $436.52 |
Where Wisconsin sits
The same service costs 3.3 times more in Alaska 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.
Wisconsin· 2nd of 51
$457
AK $490MD $148
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.