How much rates vary
Facilitymedian $1,950 · 10th to 90th $269 to $5,248Professionalmedian $479 · 10th to 90th $200 to $1,288
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 $213.80 Typical High $14,454.40 | Facility | None | $144.54 | $213.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $1,096.48 | Professional | None | $144.54 | $213.80 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $660.69 Typical High $1,318.26 | Professional | None | $208.93 | $660.69 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $537.03 Typical High $1,000.00 | Facility | None | $269.15 | $537.03 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $891.25 | Professional | None | $263.03 | $389.05 | $891.25 |
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 $263.03 Median $371.54 Typical High $537.03 | Professional | None | $263.03 | $371.54 | $537.03 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $1,479.11 Typical High $4,168.69 | Facility | None | $257.04 | $1,479.11 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $851.14 Typical High $1,659.59 | Professional | None | $218.78 | $851.14 | $1,659.59 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $616.60 | Professional | None | $269.15 | $426.58 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $398.11 | Facility | None | $134.90 | $213.80 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $524.81 Typical High $831.76 | Professional | None | $257.04 | $524.81 | $831.76 |
Quartz Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $1,071.52 | Facility | None | $263.03 | $398.11 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $467.74 | Professional | None | $263.03 | $380.19 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | None | $478.63 | $478.63 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $954.99 Typical High $1,412.54 | Professional | None | $478.63 | $954.99 | $1,412.54 |
The Alliance Setting Professional Modifier None Typical Low $245.47 Median $660.69 Typical High $1,174.90 | Professional | None | $245.47 | $660.69 | $1,174.90 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
United Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $933.25 | Professional | None | $169.82 | $338.84 | $933.25 |
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 $107.15 | Facility | 52 · Reduced service | $72.44 | $72.44 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $42.66 | Facility | 53 · Discontinued | $29.51 | $29.51 | $42.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $162.18 | Facility | 54 · Surgery only | $109.65 | $109.65 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $32.36 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $21.38 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $21.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $107.15 Typical High $602.56 | Professional | 52 · Reduced service | $72.44 | $107.15 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $42.66 Typical High $239.88 | Professional | 53 · Discontinued | $29.51 | $42.66 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $891.25 | Professional | 54 · Surgery only | $109.65 | $162.18 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $181.97 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $120.23 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $831.76 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $186.21 Typical High $269.15 | Professional | 51 · Multiple procedures | $131.83 | $186.21 | $269.15 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $295.12 Typical High $436.52 | Professional | 54 · Surgery only | $208.93 | $295.12 | $436.52 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $74.13 Typical High $107.15 | Professional | 55 · Aftercare only | $52.48 | $74.13 | $107.15 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $309.03 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $218.78 | $309.03 | $457.09 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$525
AK $603FL $174
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.