How much rates vary
Facilitymedian $1,202 · 10th to 90th $178 to $3,890Professionalmedian $447 · 10th to 90th $178 to $891
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 $117.49 Median $177.83 Typical High $14,454.40 | Facility | None | $117.49 | $177.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $1,023.29 | Professional | None | $117.49 | $177.83 | $1,023.29 |
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 $218.78 Median $524.81 Typical High $933.25 | Professional | None | $218.78 | $524.81 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $275.42 Typical High $645.65 | Facility | None | $50.12 | $275.42 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $616.60 | Professional | None | $154.88 | $257.04 | $616.60 |
DeanCare Setting Facility Modifier None Typical Low $162.18 Median $2,630.27 Typical High $5,128.61 | Facility | None | $162.18 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $549.54 | Professional | None | $239.88 | $363.08 | $549.54 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $912.01 Typical High $1,778.28 | Facility | None | $162.18 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $645.65 Typical High $1,548.82 | Professional | None | $208.93 | $645.65 | $1,548.82 |
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 $288.40 Median $416.87 Typical High $575.44 | Professional | None | $288.40 | $416.87 | $575.44 |
Prevea360 Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $398.11 | Facility | None | $125.89 | $208.93 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $660.69 | Professional | None | $223.87 | $416.87 | $660.69 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $302.00 | Facility | None | $50.12 | $199.53 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $380.19 | Professional | None | $154.88 | $234.42 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $389.05 | Professional | None | $251.19 | $251.19 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $645.65 Typical High $1,000.00 | Professional | None | $331.13 | $645.65 | $1,000.00 |
The Alliance Setting Professional Modifier None Typical Low $371.54 Median $741.31 Typical High $1,258.93 | Professional | None | $371.54 | $741.31 | $1,258.93 |
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 $158.49 Median $407.38 Typical High $794.33 | Professional | None | $158.49 | $407.38 | $794.33 |
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 $58.88 Median $58.88 Typical High $89.13 | Facility | 52 · Reduced service | $58.88 | $58.88 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $35.48 | Facility | 53 · Discontinued | $23.44 | $23.44 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $131.83 | Facility | 54 · Surgery only | $87.10 | $87.10 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $26.30 | Facility | 55 · Aftercare only | $17.78 | $17.78 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $17.78 | Facility | 56 · Pre-op care only | $11.75 | $11.75 | $17.78 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $81.28 | $81.28 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $89.13 Typical High $562.34 | Professional | 52 · Reduced service | $58.88 | $89.13 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $35.48 Typical High $223.87 | Professional | 53 · Discontinued | $23.44 | $35.48 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $131.83 Typical High $851.14 | Professional | 54 · Surgery only | $87.10 | $131.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.30 Typical High $169.82 | Professional | 55 · Aftercare only | $17.78 | $26.30 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.78 Typical High $112.20 | Professional | 56 · Pre-op care only | $11.75 | $17.78 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $123.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $81.28 | $123.03 | $794.33 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $181.97 Typical High $275.42 | Professional | 51 · Multiple procedures | $120.23 | $181.97 | $275.42 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $288.40 Typical High $436.52 | Professional | 54 · Surgery only | $190.55 | $288.40 | $436.52 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $72.44 Typical High $109.65 | Professional | 55 · Aftercare only | $47.86 | $72.44 | $109.65 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $467.74 |
Where Wisconsin sits
The same service costs 3.5 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
$490
AK $550MD $155
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.