How much rates vary
Facilitymedian $3,020 · 10th to 90th $437 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 $263.03 Median $371.54 Typical High $14,454.40 | Facility | None | $263.03 | $371.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $2,511.89 | Professional | None | $263.03 | $371.54 | $2,511.89 |
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 $354.81 Median $1,000.00 Typical High $2,187.76 | Professional | None | $354.81 | $1,000.00 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $812.83 Typical High $1,548.82 | Facility | None | $436.52 | $812.83 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $1,548.82 | Professional | None | $446.68 | $676.08 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $316.23 Median $2,630.27 Typical High $5,128.61 | Facility | None | $316.23 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,000.00 | Professional | None | $489.78 | $707.95 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $2,511.89 Typical High $8,317.64 | Facility | None | $446.68 | $2,511.89 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,548.82 Typical High $2,754.23 | Professional | None | $426.58 | $1,548.82 | $2,754.23 |
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 $467.74 Median $851.14 Typical High $1,174.90 | Professional | None | $467.74 | $851.14 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $776.25 | Facility | None | $257.04 | $416.87 | $776.25 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $891.25 Typical High $1,621.81 | Professional | None | $446.68 | $891.25 | $1,621.81 |
Quartz Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $1,479.11 | Facility | None | $426.58 | $660.69 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $812.83 | Professional | None | $478.63 | $660.69 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,230.27 | Professional | None | $851.14 | $851.14 | $1,230.27 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,454.71 | Professional | None | $954.99 | $1,698.24 | $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 $323.59 Median $630.96 Typical High $1,819.70 | Professional | None | $323.59 | $630.96 | $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 $131.83 Median $131.83 Typical High $186.21 | Facility | 52 · Reduced service | $131.83 | $131.83 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $74.13 | Facility | 53 · Discontinued | $52.48 | $52.48 | $74.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $275.42 | Facility | 54 · Surgery only | $194.98 | $194.98 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $56.23 | Facility | 55 · Aftercare only | $38.90 | $38.90 | $56.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $37.15 | Facility | 56 · Pre-op care only | $26.30 | $26.30 | $37.15 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $181.97 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $186.21 Typical High $1,258.93 | Professional | 52 · Reduced service | $131.83 | $186.21 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $74.13 Typical High $501.19 | Professional | 53 · Discontinued | $52.48 | $74.13 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $275.42 Typical High $1,905.46 | Professional | 54 · Surgery only | $194.98 | $275.42 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $380.19 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $37.15 Typical High $251.19 | Professional | 56 · Pre-op care only | $26.30 | $37.15 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $257.04 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $181.97 | $257.04 | $1,778.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $245.47 Median $346.74 Typical High $501.19 | Professional | 51 · Multiple procedures | $245.47 | $346.74 | $501.19 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $562.34 Typical High $794.33 | Professional | 54 · Surgery only | $398.11 | $562.34 | $794.33 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $141.25 Typical High $199.53 | Professional | 55 · Aftercare only | $97.72 | $141.25 | $199.53 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $588.84 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $416.87 | $588.84 | $831.76 |
Where Wisconsin sits
The same service costs 5.2 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
$891
AK $1,148TX $219
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.