How much rates vary
Facilitymedian $1,230 · 10th to 90th $214 to $4,074Professionalmedian $537 · 10th to 90th $209 to $1,072
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 $144.54 Median $208.93 Typical High $14,454.40 | Facility | None | $144.54 | $208.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $1,412.54 | Professional | None | $144.54 | $208.93 | $1,412.54 |
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 $263.03 Median $645.65 Typical High $1,096.48 | Professional | None | $263.03 | $645.65 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $588.84 Typical High $1,071.52 | Facility | None | $245.47 | $588.84 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $741.31 | Professional | None | $190.55 | $309.03 | $741.31 |
DeanCare Setting Facility Modifier None Typical Low $186.21 Median $3,162.28 Typical High $5,888.44 | Facility | None | $186.21 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $660.69 | Professional | None | $295.12 | $436.52 | $660.69 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $912.01 Typical High $1,778.28 | Facility | None | $186.21 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $776.25 Typical High $1,819.70 | Professional | None | $251.19 | $776.25 | $1,819.70 |
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 $338.84 Median $512.86 Typical High $691.83 | Professional | None | $338.84 | $512.86 | $691.83 |
Prevea360 Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $478.63 | Facility | None | $154.88 | $239.88 | $478.63 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $794.33 | Professional | None | $263.03 | $501.19 | $794.33 |
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 $190.55 Median $281.84 Typical High $457.09 | Professional | None | $190.55 | $281.84 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $457.09 | Professional | None | $309.03 | $309.03 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $407.38 Median $794.33 Typical High $1,174.90 | Professional | None | $407.38 | $794.33 | $1,174.90 |
The Alliance Setting Professional Modifier None Typical Low $446.68 Median $870.96 Typical High $1,621.81 | Professional | None | $446.68 | $870.96 | $1,621.81 |
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 $194.98 Median $489.78 Typical High $954.99 | Professional | None | $194.98 | $489.78 | $954.99 |
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 $72.44 Median $72.44 Typical High $104.71 | Facility | 52 · Reduced service | $72.44 | $72.44 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $41.69 | Facility | 53 · Discontinued | $28.84 | $28.84 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $158.49 | Facility | 54 · Surgery only | $107.15 | $107.15 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $31.62 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $20.89 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $100.00 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $104.71 Typical High $691.83 | Professional | 52 · Reduced service | $72.44 | $104.71 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $281.84 | Professional | 53 · Discontinued | $28.84 | $41.69 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $1,047.13 | Professional | 54 · Surgery only | $107.15 | $158.49 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $208.93 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $977.24 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $213.80 Typical High $331.13 | Professional | 51 · Multiple procedures | $147.91 | $213.80 | $331.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $346.74 Typical High $524.81 | Professional | 54 · Surgery only | $234.42 | $346.74 | $524.81 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $87.10 Typical High $131.83 | Professional | 55 · Aftercare only | $58.88 | $87.10 | $131.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $549.54 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$603
AK $676TX $191
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.