How much rates vary
Facilitymedian $3,090 · 10th to 90th $891 to $6,310Professionalmedian $2,239 · 10th to 90th $832 to $6,310
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 $831.76 Median $6,456.54 Typical High $14,454.40 | Facility | None | $831.76 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $8,317.64 | Professional | None | $831.76 | $831.76 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $3,019.95 Typical High $6,309.57 | Professional | None | $794.33 | $3,019.95 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,238.72 Typical High $3,311.31 | Facility | None | $1,023.29 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,513.56 | $3,981.07 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $4,365.16 Typical High $7,762.47 | Facility | None | $933.25 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,819.70 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,187.76 Typical High $4,786.30 | Facility | None | $645.65 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,137.96 Typical High $6,456.54 | Professional | None | $870.96 | $2,137.96 | $6,456.54 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $8,128.31 | Facility | None | $1,548.82 | $2,818.38 | $8,128.31 |
Network Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,995.26 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,778.28 | Facility | None | $776.25 | $933.25 | $1,778.28 |
Quartz Setting Professional Modifier None Typical Low $1,047.13 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,047.13 | $2,398.83 | $3,630.78 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $3,162.28 | Facility | None | $812.83 | $1,995.26 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,513.56 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $5,888.44 | Professional | None | $2,691.53 | $4,265.80 | $5,888.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,737.80 Typical High $3,981.07 | Professional | None | $851.14 | $1,737.80 | $3,981.07 |
10 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 Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $4,168.69 | Professional | 52 · Reduced service | $416.87 | $416.87 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,659.59 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $6,309.57 | Professional | 54 · Surgery only | $630.96 | $630.96 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $1,258.93 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $831.76 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $5,888.44 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $741.31 | $912.01 | $1,318.26 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $2,089.30 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $363.08 Typical High $524.81 | Professional | 55 · Aftercare only | $295.12 | $363.08 | $524.81 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,548.82 | $2,238.72 |
Where Wisconsin sits
The same service costs 7.6 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
$2,512
AK $3,715TX $490
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.