How much rates vary
Facilitymedian $1,380 · 10th to 90th $59 to $4,074Professionalmedian $141 · 10th to 90th $50 to $234
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 $41.69 Median $45.71 Typical High $14,454.40 | Facility | None | $41.69 | $45.71 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $323.59 | Professional | None | $41.69 | $45.71 | $323.59 |
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 $70.79 Median $158.49 Typical High $239.88 | Professional | None | $70.79 | $158.49 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $141.25 Typical High $213.80 | Facility | None | $50.12 | $141.25 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $162.18 | Professional | None | $52.48 | $75.86 | $162.18 |
DeanCare Setting Facility Modifier None Typical Low $45.71 Median $2,630.27 Typical High $5,128.61 | Facility | None | $45.71 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $144.54 | Professional | None | $87.10 | $93.33 | $144.54 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $912.01 Typical High $1,778.28 | Facility | None | $74.13 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $53.70 Median $169.82 Typical High $389.05 | Professional | None | $53.70 | $169.82 | $389.05 |
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 $72.44 Median $112.20 Typical High $144.54 | Professional | None | $72.44 | $112.20 | $144.54 |
Prevea360 Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $102.33 | Facility | None | $38.02 | $57.54 | $102.33 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $208.93 | Professional | None | $70.79 | $125.89 | $208.93 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $120.23 | Professional | None | $50.12 | $60.26 | $120.23 |
Security Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
Security Health Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $263.03 | Professional | None | $93.33 | $208.93 | $263.03 |
United Setting Facility Modifier None Typical Low $204.17 Median $1,148.15 Typical High $1,862.09 | Facility | None | $204.17 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $50.12 Median $117.49 Typical High $208.93 | Professional | None | $50.12 | $117.49 | $208.93 |
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 $20.89 Median $20.89 Typical High $22.39 | Facility | 52 · Reduced service | $20.89 | $20.89 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $9.12 | Facility | 53 · Discontinued | $8.51 | $8.51 | $9.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $33.88 | Facility | 54 · Surgery only | $31.62 | $31.62 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.76 | Facility | 55 · Aftercare only | $6.31 | $6.31 | $6.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.57 | Facility | 56 · Pre-op care only | $4.17 | $4.17 | $4.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $29.51 Typical High $31.62 | Facility | 78 · Unplanned return to OR | $29.51 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $22.39 Typical High $162.18 | Professional | 52 · Reduced service | $20.89 | $22.39 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $66.07 | Professional | 53 · Discontinued | $8.51 | $9.12 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.88 Typical High $245.47 | Professional | 54 · Surgery only | $31.62 | $33.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.76 Typical High $48.98 | Professional | 55 · Aftercare only | $6.31 | $6.76 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.57 Typical High $32.36 | Professional | 56 · Pre-op care only | $4.17 | $4.57 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $31.62 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $29.51 | $31.62 | $229.09 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $43.65 Median $46.77 Typical High $72.44 | Professional | 51 · Multiple procedures | $43.65 | $46.77 | $72.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $74.13 Typical High $117.49 | Professional | 54 · Surgery only | $69.18 | $74.13 | $117.49 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $29.51 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $77.62 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $72.44 | $77.62 | $123.03 |
Where Wisconsin sits
The same service costs 4.6 times more in Alaska than in New York. 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
$158
AK $200NY $43.65
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.