How much rates vary
Facilitymedian $2,042 · 10th to 90th $309 to $5,248Professionalmedian $468 · 10th to 90th $209 to $1,202
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 $251.19 Typical High $14,454.40 | Facility | None | $151.36 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $1,096.48 | Professional | None | $151.36 | $251.19 | $1,096.48 |
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 $562.34 Typical High $1,174.90 | Professional | None | $208.93 | $562.34 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,071.52 | Facility | None | $309.03 | $602.56 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $1,047.13 | Professional | None | $275.42 | $446.68 | $1,047.13 |
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 $281.84 Median $446.68 Typical High $660.69 | Professional | None | $281.84 | $446.68 | $660.69 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $1,479.11 Typical High $3,311.31 | Facility | None | $295.12 | $1,479.11 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,023.29 Typical High $1,905.46 | Professional | None | $275.42 | $1,023.29 | $1,905.46 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $724.44 | Professional | None | $316.23 | $501.19 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $489.78 | Facility | None | $141.25 | $245.47 | $489.78 |
Quartz Setting Professional Modifier None Typical Low $295.12 Median $602.56 Typical High $1,047.13 | Professional | None | $295.12 | $602.56 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $309.03 Median $426.58 Typical High $1,071.52 | Facility | None | $309.03 | $426.58 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $537.03 | Professional | None | $275.42 | $446.68 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $851.14 | Professional | None | $501.19 | $501.19 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $1,659.59 | Professional | None | $524.81 | $977.24 | $1,659.59 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
United Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $1,096.48 | Professional | None | $186.21 | $389.05 | $1,096.48 |
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 $123.03 | Facility | 52 · Reduced service | $75.86 | $75.86 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $50.12 | Facility | 53 · Discontinued | $30.20 | $30.20 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $186.21 | Facility | 54 · Surgery only | $114.82 | $114.82 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $37.15 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $25.12 | Facility | 56 · Pre-op care only | $15.14 | $15.14 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $123.03 Typical High $537.03 | Professional | 52 · Reduced service | $75.86 | $123.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $50.12 Typical High $218.78 | Professional | 53 · Discontinued | $30.20 | $50.12 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $186.21 Typical High $812.83 | Professional | 54 · Surgery only | $114.82 | $186.21 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $37.15 Typical High $162.18 | Professional | 55 · Aftercare only | $22.91 | $37.15 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $25.12 Typical High $109.65 | Professional | 56 · Pre-op care only | $15.14 | $25.12 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $173.78 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $107.15 | $173.78 | $758.58 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $141.25 Median $223.87 Typical High $331.13 | Professional | 51 · Multiple procedures | $141.25 | $223.87 | $331.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $363.08 Typical High $537.03 | Professional | 54 · Surgery only | $229.09 | $363.08 | $537.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $57.54 | $89.13 | $134.90 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $380.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $239.88 | $380.19 | $562.34 |
Where Wisconsin sits
The same service costs 4.4 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
$562
AK $661KY $151
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.