How much rates vary
Facilitymedian $2,570 · 10th to 90th $468 to $5,623Professionalmedian $562 · 10th to 90th $195 to $1,549
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 $346.74 Typical High $14,454.40 | Facility | None | $144.54 | $346.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $2,511.89 | Professional | None | $144.54 | $338.84 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $524.81 Typical High $1,122.02 | Professional | None | $194.98 | $524.81 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,949.84 | Facility | None | $707.95 | $1,202.26 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $602.56 Typical High $1,479.11 | Professional | None | $257.04 | $602.56 | $1,479.11 |
DeanCare Setting Facility Modifier None Typical Low $169.82 Median $2,570.40 Typical High $4,786.30 | Facility | None | $169.82 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $870.96 | Professional | None | $257.04 | $489.78 | $870.96 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $2,344.23 Typical High $4,786.30 | Facility | None | $407.38 | $2,344.23 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,348.96 Typical High $2,818.38 | Professional | None | $426.58 | $1,348.96 | $2,818.38 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $354.81 Median $645.65 Typical High $1,071.52 | Professional | None | $354.81 | $645.65 | $1,071.52 |
Prevea360 Setting Facility Modifier None Typical Low $134.90 Median $295.12 Typical High $691.83 | Facility | None | $134.90 | $295.12 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $1,548.82 | Professional | None | $309.03 | $630.96 | $1,548.82 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $2,041.74 | Facility | None | $630.96 | $1,348.96 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $562.34 Typical High $724.44 | Professional | None | $257.04 | $562.34 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,202.26 | Professional | None | $467.74 | $467.74 | $1,202.26 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $2,398.83 | Professional | None | $478.63 | $1,096.48 | $2,398.83 |
The Alliance Setting Professional Modifier None Typical Low $389.05 Median $851.14 Typical High $2,187.76 | Professional | None | $389.05 | $851.14 | $2,187.76 |
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 $173.78 Median $512.86 Typical High $1,548.82 | Professional | None | $173.78 | $512.86 | $1,548.82 |
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 $70.79 Median $70.79 Typical High $173.78 | Facility | 52 · Reduced service | $70.79 | $70.79 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $69.18 | Facility | 53 · Discontinued | $28.84 | $28.84 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $257.04 | Facility | 54 · Surgery only | $107.15 | $107.15 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $51.29 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $34.67 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $100.00 | $100.00 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $173.78 Typical High $1,348.96 | Professional | 52 · Reduced service | $70.79 | $173.78 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $69.18 Typical High $537.03 | Professional | 53 · Discontinued | $28.84 | $69.18 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $257.04 Typical High $2,041.74 | Professional | 54 · Surgery only | $107.15 | $257.04 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $51.29 Typical High $407.38 | Professional | 55 · Aftercare only | $21.38 | $51.29 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $34.67 Typical High $269.15 | Professional | 56 · Pre-op care only | $14.45 | $34.67 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $239.88 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $100.00 | $239.88 | $1,905.46 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $128.82 Median $245.47 Typical High $436.52 | Professional | 51 · Multiple procedures | $128.82 | $245.47 | $436.52 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $389.05 Typical High $691.83 | Professional | 54 · Surgery only | $204.17 | $389.05 | $691.83 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $97.72 Typical High $173.78 | Professional | 55 · Aftercare only | $51.29 | $97.72 | $173.78 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $407.38 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $213.80 | $407.38 | $741.31 |
Where Wisconsin sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$631
AK $759KY $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.