How much rates vary
Facilitymedian $6,918 · 10th to 90th $955 to $14,454Professionalmedian $1,778 · 10th to 90th $794 to $5,012
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 $660.69 Median $794.33 Typical High $14,454.40 | Facility | None | $660.69 | $794.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $5,495.41 | Professional | None | $660.69 | $794.33 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $2,511.89 Typical High $5,623.41 | Professional | None | $831.76 | $2,511.89 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $7,585.78 | Facility | None | $1,000.00 | $2,884.03 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,445.44 | $3,311.31 |
DeanCare Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $5,370.32 | Facility | None | $741.31 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,621.81 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $5,754.40 Typical High $15,848.93 | Facility | None | $954.99 | $5,754.40 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $3,311.31 Typical High $5,888.44 | Professional | None | $977.24 | $3,311.31 | $5,888.44 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,000.00 | $2,089.30 | $2,511.89 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $891.25 Typical High $1,479.11 | Facility | None | $575.44 | $891.25 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,995.26 | $3,467.37 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $5,011.87 Typical High $8,317.64 | Facility | None | $724.44 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,445.44 | $1,737.80 |
Security Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,187.76 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $2,454.71 Median $4,265.80 Typical High $5,128.61 | Professional | None | $2,454.71 | $4,265.80 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,621.81 Typical High $3,890.45 | Professional | None | $831.76 | $1,621.81 | $3,890.45 |
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 $331.13 Median $331.13 Typical High $398.11 | Facility | 52 · Reduced service | $331.13 | $331.13 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $158.49 | Facility | 53 · Discontinued | $131.83 | $131.83 | $158.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $602.56 | Facility | 54 · Surgery only | $501.19 | $501.19 | $602.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $120.23 | Facility | 55 · Aftercare only | $100.00 | $100.00 | $120.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $79.43 | Facility | 56 · Pre-op care only | $66.07 | $66.07 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $562.34 | Facility | 78 · Unplanned return to OR | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $398.11 Typical High $2,754.23 | Professional | 52 · Reduced service | $331.13 | $398.11 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $158.49 Typical High $1,096.48 | Professional | 53 · Discontinued | $131.83 | $158.49 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $4,168.69 | Professional | 54 · Surgery only | $501.19 | $602.56 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $120.23 Typical High $831.76 | Professional | 55 · Aftercare only | $100.00 | $120.23 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $79.43 Typical High $549.54 | Professional | 56 · Pre-op care only | $66.07 | $79.43 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $562.34 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $467.74 | $562.34 | $3,890.45 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | 51 · Multiple procedures | $616.60 | $812.83 | $1,202.26 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,288.25 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,000.00 | $1,288.25 | $1,905.46 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $323.59 Typical High $478.63 | Professional | 55 · Aftercare only | $251.19 | $323.59 | $478.63 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,380.38 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,380.38 | $1,995.26 |
Where Wisconsin sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$2,138
AK $3,236UT $562
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.