How much rates vary
Facilitymedian $1,202 · 10th to 90th $138 to $3,802Professionalmedian $316 · 10th to 90th $126 to $646
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 $83.18 Median $128.82 Typical High $14,454.40 | Facility | None | $83.18 | $128.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $724.44 | Professional | None | $83.18 | $128.82 | $724.44 |
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 $151.36 Median $371.54 Typical High $676.08 | Professional | None | $151.36 | $371.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $467.74 | Facility | None | $50.12 | $245.47 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $457.09 | Professional | None | $109.65 | $190.55 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $107.15 Median $2,630.27 Typical High $5,128.61 | Facility | None | $107.15 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $398.11 | Professional | None | $169.82 | $263.03 | $398.11 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $912.01 Typical High $1,778.28 | Facility | None | $144.54 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $478.63 Typical High $1,122.02 | Professional | None | $151.36 | $478.63 | $1,122.02 |
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 $208.93 Median $288.40 Typical High $426.58 | Professional | None | $208.93 | $288.40 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $138.04 Typical High $288.40 | Facility | None | $79.43 | $138.04 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $489.78 | Professional | None | $162.18 | $302.00 | $489.78 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $177.83 Typical High $269.15 | Facility | None | $50.12 | $177.83 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $269.15 | Professional | None | $109.65 | $173.78 | $269.15 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | None | $173.78 | $173.78 | $281.84 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $457.09 Typical High $724.44 | Professional | None | $229.09 | $457.09 | $724.44 |
The Alliance Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | None | $562.34 | $562.34 | $707.95 |
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 $109.65 Median $288.40 Typical High $588.84 | Professional | None | $109.65 | $288.40 | $588.84 |
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 $41.69 Median $41.69 Typical High $64.57 | Facility | 52 · Reduced service | $41.69 | $41.69 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $25.70 | Facility | 53 · Discontinued | $16.60 | $16.60 | $25.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $97.72 | Facility | 54 · Surgery only | $61.66 | $61.66 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $19.50 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $12.88 | Facility | 56 · Pre-op care only | $8.32 | $8.32 | $12.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $57.54 Typical High $91.20 | Facility | 78 · Unplanned return to OR | $57.54 | $57.54 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $64.57 Typical High $398.11 | Professional | 52 · Reduced service | $41.69 | $64.57 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.70 Typical High $158.49 | Professional | 53 · Discontinued | $16.60 | $25.70 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $97.72 Typical High $602.56 | Professional | 54 · Surgery only | $61.66 | $97.72 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.50 Typical High $120.23 | Professional | 55 · Aftercare only | $12.30 | $19.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.88 Typical High $79.43 | Professional | 56 · Pre-op care only | $8.32 | $12.88 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $91.20 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $57.54 | $91.20 | $562.34 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $131.83 Typical High $199.53 | Professional | 51 · Multiple procedures | $85.11 | $131.83 | $199.53 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $213.80 Typical High $323.59 | Professional | 54 · Surgery only | $134.90 | $213.80 | $323.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $52.48 Typical High $81.28 | Professional | 55 · Aftercare only | $33.88 | $52.48 | $81.28 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $338.84 |
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
$355
AK $389KY $110
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.