How much rates vary
Facilitymedian $1,202 · 10th to 90th $145 to $3,890Professionalmedian $347 · 10th to 90th $141 to $724
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 $91.20 Median $144.54 Typical High $14,454.40 | Facility | None | $91.20 | $144.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $812.83 | Professional | None | $91.20 | $144.54 | $812.83 |
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 $173.78 Median $407.38 Typical High $758.58 | Professional | None | $173.78 | $407.38 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $269.15 Typical High $524.81 | Facility | None | $50.12 | $269.15 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $501.19 | Professional | None | $120.23 | $208.93 | $501.19 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $2,630.27 Typical High $5,128.61 | Facility | None | $117.49 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $446.68 | Professional | None | $186.21 | $295.12 | $446.68 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $912.01 Typical High $1,778.28 | Facility | None | $151.36 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $524.81 Typical High $1,258.93 | Professional | None | $165.96 | $524.81 | $1,258.93 |
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 $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $97.72 Median $154.88 Typical High $316.23 | Facility | None | $97.72 | $154.88 | $316.23 |
Quartz Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $537.03 | Professional | None | $181.97 | $331.13 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $194.98 Typical High $295.12 | Facility | None | $50.12 | $194.98 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $295.12 | Professional | None | $120.23 | $190.55 | $295.12 |
Security Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $316.23 | Professional | None | $194.98 | $194.98 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $812.83 | Professional | None | $257.04 | $501.19 | $812.83 |
The Alliance Setting Professional Modifier None Typical Low $181.97 Median $426.58 Typical High $1,000.00 | Professional | None | $181.97 | $426.58 | $1,000.00 |
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 $123.03 Median $316.23 Typical High $630.96 | Professional | None | $123.03 | $316.23 | $630.96 |
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 $45.71 Median $45.71 Typical High $70.79 | Facility | 52 · Reduced service | $45.71 | $45.71 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $28.84 | Facility | 53 · Discontinued | $18.20 | $18.20 | $28.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $107.15 | Facility | 54 · Surgery only | $67.61 | $67.61 | $107.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $21.38 | Facility | 55 · Aftercare only | $13.49 | $13.49 | $21.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $14.45 | Facility | 56 · Pre-op care only | $9.12 | $9.12 | $14.45 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $63.10 Typical High $100.00 | Facility | 78 · Unplanned return to OR | $63.10 | $63.10 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $70.79 Typical High $446.68 | Professional | 52 · Reduced service | $45.71 | $70.79 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $177.83 | Professional | 53 · Discontinued | $18.20 | $28.84 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $107.15 Typical High $660.69 | Professional | 54 · Surgery only | $67.61 | $107.15 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $131.83 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $89.13 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $100.00 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $63.10 | $100.00 | $616.60 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $93.33 Median $147.91 Typical High $223.87 | Professional | 51 · Multiple procedures | $93.33 | $147.91 | $223.87 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $354.81 | Professional | 54 · Surgery only | $147.91 | $234.42 | $354.81 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $58.88 Typical High $89.13 | Professional | 55 · Aftercare only | $37.15 | $58.88 | $89.13 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $245.47 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $158.49 | $245.47 | $380.19 |
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
$389
AK $427KY $123
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.