How much rates vary
Facilitymedian $2,570 · 10th to 90th $427 to $5,623Professionalmedian $479 · 10th to 90th $209 to $1,259
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 $151.36 Median $257.04 Typical High $14,454.40 | Facility | None | $151.36 | $257.04 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $1,584.89 | Professional | None | $151.36 | $257.04 | $1,584.89 |
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 $208.93 Median $575.44 Typical High $1,202.26 | Professional | None | $208.93 | $575.44 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,862.09 | Facility | None | $707.95 | $1,096.48 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $1,096.48 | Professional | None | $275.42 | $467.74 | $1,096.48 |
DeanCare Setting Facility Modifier None Typical Low $169.82 Median $2,630.27 Typical High $5,128.61 | Facility | None | $169.82 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $691.83 | Professional | None | $288.40 | $467.74 | $691.83 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $2,187.76 Typical High $4,365.16 | Facility | None | $309.03 | $2,187.76 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,047.13 Typical High $1,995.26 | Professional | None | $281.84 | $1,047.13 | $1,995.26 |
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 $331.13 Median $489.78 Typical High $741.31 | Professional | None | $331.13 | $489.78 | $741.31 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $501.19 | Facility | None | $141.25 | $245.47 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $1,071.52 | Professional | None | $302.00 | $616.60 | $1,071.52 |
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 $275.42 Median $426.58 Typical High $562.34 | Professional | None | $275.42 | $426.58 | $562.34 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $891.25 | Professional | None | $501.19 | $501.19 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,737.80 | Professional | None | $512.86 | $1,000.00 | $1,737.80 |
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 $181.97 Median $398.11 Typical High $1,122.02 | Professional | None | $181.97 | $398.11 | $1,122.02 |
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 $75.86 Median $75.86 Typical High $128.82 | Facility | 52 · Reduced service | $75.86 | $75.86 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $52.48 | Facility | 53 · Discontinued | $30.20 | $30.20 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $194.98 | Facility | 54 · Surgery only | $114.82 | $114.82 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $38.90 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $25.70 | Facility | 56 · Pre-op care only | $15.14 | $15.14 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $128.82 Typical High $794.33 | Professional | 52 · Reduced service | $75.86 | $128.82 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $52.48 Typical High $316.23 | Professional | 53 · Discontinued | $30.20 | $52.48 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $194.98 Typical High $1,202.26 | Professional | 54 · Surgery only | $114.82 | $194.98 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $38.90 Typical High $239.88 | Professional | 55 · Aftercare only | $22.91 | $38.90 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $25.70 Typical High $158.49 | Professional | 56 · Pre-op care only | $15.14 | $25.70 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $181.97 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $107.15 | $181.97 | $1,122.02 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $234.42 Typical High $346.74 | Professional | 51 · Multiple procedures | $144.54 | $234.42 | $346.74 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $371.54 Typical High $562.34 | Professional | 54 · Surgery only | $229.09 | $371.54 | $562.34 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $93.33 Typical High $138.04 | Professional | 55 · Aftercare only | $57.54 | $93.33 | $138.04 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $389.05 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $239.88 | $389.05 | $588.84 |
Where Wisconsin sits
The same service costs 4.5 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
$589
AK $759KY $170
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.