How much rates vary
Facilitymedian $3,090 · 10th to 90th $447 to $7,762Professionalmedian $794 · 10th to 90th $355 to $2,042
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 $269.15 Median $380.19 Typical High $14,454.40 | Facility | None | $269.15 | $380.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $2,398.83 | Professional | None | $269.15 | $380.19 | $2,398.83 |
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 $371.54 Median $1,047.13 Typical High $2,187.76 | Professional | None | $371.54 | $1,047.13 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $1,584.89 Typical High $3,235.94 | Professional | 50 · Both sides | $549.54 | $1,584.89 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $831.76 Typical High $1,584.89 | Facility | None | $446.68 | $831.76 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,584.89 | Professional | None | $457.09 | $691.83 | $1,584.89 |
DeanCare Setting Facility Modifier None Typical Low $323.59 Median $3,162.28 Typical High $5,888.44 | Facility | None | $323.59 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,023.29 | Professional | None | $512.86 | $724.44 | $1,023.29 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,096.48 Typical High $1,513.56 | Professional | 50 · Both sides | $758.58 | $1,096.48 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $2,511.89 Typical High $8,317.64 | Facility | None | $457.09 | $2,511.89 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,548.82 Typical High $2,884.03 | Professional | None | $426.58 | $1,548.82 | $2,884.03 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $1,174.90 | Professional | None | $478.63 | $851.14 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $758.58 | Facility | None | $269.15 | $416.87 | $758.58 |
Quartz Setting Professional Modifier None Typical Low $467.74 Median $912.01 Typical High $1,621.81 | Professional | None | $467.74 | $912.01 | $1,621.81 |
Quartz Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $1,288.25 | Facility | None | $446.68 | $645.65 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $812.83 | Professional | None | $489.78 | $676.08 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,288.25 | Professional | None | $891.25 | $891.25 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $977.24 Median $1,778.28 Typical High $2,454.71 | Professional | None | $977.24 | $1,778.28 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $331.13 Median $645.65 Typical High $1,819.70 | Professional | None | $331.13 | $645.65 | $1,819.70 |
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 $134.90 Median $134.90 Typical High $190.55 | Facility | 52 · Reduced service | $134.90 | $134.90 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $75.86 | Facility | 53 · Discontinued | $53.70 | $53.70 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $281.84 | Facility | 54 · Surgery only | $204.17 | $204.17 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $56.23 | Facility | 55 · Aftercare only | $40.74 | $40.74 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $38.02 | Facility | 56 · Pre-op care only | $26.92 | $26.92 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $190.55 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $190.55 Typical High $1,202.26 | Professional | 52 · Reduced service | $134.90 | $190.55 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $75.86 Typical High $478.63 | Professional | 53 · Discontinued | $53.70 | $75.86 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $281.84 Typical High $1,819.70 | Professional | 54 · Surgery only | $204.17 | $281.84 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $56.23 Typical High $363.08 | Professional | 55 · Aftercare only | $40.74 | $56.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $38.02 Typical High $239.88 | Professional | 56 · Pre-op care only | $26.92 | $38.02 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $263.03 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $190.55 | $263.03 | $1,698.24 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $363.08 Typical High $512.86 | Professional | 51 · Multiple procedures | $257.04 | $363.08 | $512.86 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $575.44 Typical High $812.83 | Professional | 54 · Surgery only | $407.38 | $575.44 | $812.83 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $204.17 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $616.60 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $426.58 | $616.60 | $851.14 |
Where Wisconsin sits
The same service costs 4.8 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
$912
AK $1,122TX $234
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.