How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,349 to $12,303Professionalmedian $3,715 · 10th to 90th $1,660 to $10,000
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 $1,318.26 Median $1,318.26 Typical High $1,659.59 | Facility | None | $1,318.26 | $1,318.26 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $15,488.17 | Professional | None | $1,318.26 | $1,659.59 | $15,488.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,818.38 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $5,128.61 Typical High $11,220.18 | Professional | None | $1,698.24 | $5,128.61 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,041.74 Typical High $5,248.07 | Facility | None | $1,023.29 | $2,041.74 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $6,918.31 | Professional | None | $2,187.76 | $3,019.95 | $6,918.31 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,548.82 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $2,454.71 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,454.71 | $3,311.31 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $5,754.40 Typical High $12,882.50 | Facility | None | $1,230.27 | $5,754.40 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $6,918.31 Typical High $12,302.69 | Professional | None | $2,041.74 | $6,918.31 | $12,302.69 |
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 $2,089.30 Median $4,365.16 Typical High $5,370.32 | Professional | None | $2,089.30 | $4,365.16 | $5,370.32 |
Prevea360 Setting Facility Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,467.37 | Facility | None | $1,318.26 | $1,862.09 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $7,244.36 | Professional | None | $2,089.30 | $3,981.07 | $7,244.36 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,511.89 | Facility | None | $812.83 | $1,513.56 | $2,511.89 |
Quartz Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,715.35 | Professional | None | $2,398.83 | $3,019.95 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,495.41 | Professional | None | $4,365.16 | $4,365.16 | $5,495.41 |
Security Health Setting Professional Modifier None Typical Low $5,623.41 Median $8,511.38 Typical High $10,715.19 | Professional | None | $5,623.41 | $8,511.38 | $10,715.19 |
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 $1,659.59 Median $3,235.94 Typical High $8,317.64 | Professional | None | $1,659.59 | $3,235.94 | $8,317.64 |
14 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 $660.69 Median $660.69 Typical High $831.76 | Facility | 52 · Reduced service | $660.69 | $660.69 | $831.76 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $331.13 | Facility | 53 · Discontinued | $263.03 | $263.03 | $331.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $251.19 | Facility | 55 · Aftercare only | $194.98 | $194.98 | $251.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $165.96 | Facility | 56 · Pre-op care only | $131.83 | $131.83 | $165.96 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Facility | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $831.76 Typical High $7,762.47 | Professional | 52 · Reduced service | $660.69 | $831.76 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $331.13 Typical High $3,090.30 | Professional | 53 · Discontinued | $263.03 | $331.13 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $2,344.23 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $165.96 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $131.83 | $165.96 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,174.90 Typical High $10,964.78 | Professional | 78 · Unplanned return to OR | $912.01 | $1,174.90 | $10,964.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,659.59 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,230.27 | $1,659.59 | $2,511.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,691.53 Typical High $3,981.07 | Professional | 54 · Surgery only | $1,949.84 | $2,691.53 | $3,981.07 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $660.69 Typical High $1,000.00 | Professional | 55 · Aftercare only | $489.78 | $660.69 | $1,000.00 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,818.38 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,818.38 | $4,265.80 |
Where Wisconsin sits
The same service costs 5.1 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
$3,802
AK $5,248TX $1,023
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.