How much rates vary
Facilitymedian $1,230 · 10th to 90th $214 to $3,802Professionalmedian $501 · 10th to 90th $204 to $1,023
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 $131.83 Median $204.17 Typical High $14,454.40 | Facility | None | $131.83 | $204.17 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $1,548.82 | Professional | None | $131.83 | $204.17 | $1,548.82 |
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 $245.47 Median $588.84 Typical High $1,071.52 | Professional | None | $245.47 | $588.84 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $562.34 Typical High $1,071.52 | Facility | None | $245.47 | $562.34 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $707.95 | Professional | None | $173.78 | $295.12 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $181.97 Median $3,162.28 Typical High $5,888.44 | Facility | None | $181.97 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $630.96 | Professional | None | $269.15 | $416.87 | $630.96 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $912.01 Typical High $1,778.28 | Facility | None | $181.97 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $741.31 Typical High $1,778.28 | Professional | None | $239.88 | $741.31 | $1,778.28 |
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 $323.59 Median $467.74 Typical High $660.69 | Professional | None | $323.59 | $467.74 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $457.09 | Facility | None | $141.25 | $234.42 | $457.09 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $758.58 | Professional | None | $257.04 | $467.74 | $758.58 |
Quartz Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $1,071.52 | Facility | None | $239.88 | $363.08 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $426.58 | Professional | None | $173.78 | $269.15 | $426.58 |
Security Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $446.68 | Professional | None | $281.84 | $281.84 | $446.68 |
Security Health Setting Professional Modifier None Typical Low $371.54 Median $741.31 Typical High $1,148.15 | Professional | None | $371.54 | $741.31 | $1,148.15 |
The Alliance Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $851.14 | Professional | None | $549.54 | $549.54 | $851.14 |
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 $181.97 Median $457.09 Typical High $891.25 | Professional | None | $181.97 | $457.09 | $891.25 |
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 $66.07 Median $66.07 Typical High $100.00 | Facility | 52 · Reduced service | $66.07 | $66.07 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $40.74 | Facility | 53 · Discontinued | $26.30 | $26.30 | $40.74 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $151.36 | Facility | 54 · Surgery only | $97.72 | $97.72 | $151.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $30.20 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $20.42 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $20.42 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $141.25 | Facility | 78 · Unplanned return to OR | $91.20 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $100.00 Typical High $776.25 | Professional | 52 · Reduced service | $66.07 | $100.00 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $40.74 Typical High $309.03 | Professional | 53 · Discontinued | $26.30 | $40.74 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $1,148.15 | Professional | 54 · Surgery only | $97.72 | $151.36 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $234.42 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $20.42 Typical High $154.88 | Professional | 56 · Pre-op care only | $13.18 | $20.42 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $141.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $91.20 | $141.25 | $1,071.52 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $134.90 Median $208.93 Typical High $316.23 | Professional | 51 · Multiple procedures | $134.90 | $208.93 | $316.23 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $331.13 Typical High $501.19 | Professional | 54 · Surgery only | $213.80 | $331.13 | $501.19 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $83.18 Typical High $125.89 | Professional | 55 · Aftercare only | $53.70 | $83.18 | $125.89 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $346.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $229.09 | $346.74 | $537.03 |
Where Wisconsin sits
The same service costs 3.5 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
$562
AK $617KY $178
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.