How much rates vary
Facilitymedian $1,259 · 10th to 90th $288 to $3,802Professionalmedian $692 · 10th to 90th $309 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 $295.12 Median $309.03 Typical High $14,454.40 | Facility | None | $295.12 | $309.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $2,398.83 | Professional | None | $295.12 | $309.03 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $1,122.02 Typical High $2,187.76 | Professional | None | $295.12 | $1,122.02 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $1,096.48 | Facility | None | $229.09 | $630.96 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $1,445.44 | Professional | None | $467.74 | $549.54 | $1,445.44 |
DeanCare Setting Facility Modifier None Typical Low $331.13 Median $2,570.40 Typical High $4,786.30 | Facility | None | $331.13 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $933.25 | Professional | None | $549.54 | $645.65 | $933.25 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $912.01 Typical High $1,995.26 | Facility | None | $257.04 | $912.01 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,174.90 Typical High $2,344.23 | Professional | None | $323.59 | $1,174.90 | $2,344.23 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $933.25 | Professional | None | $389.05 | $707.95 | $933.25 |
Prevea360 Setting Facility Modifier None Typical Low $288.40 Median $363.08 Typical High $616.60 | Facility | None | $288.40 | $363.08 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $1,348.96 | Professional | None | $478.63 | $831.76 | $1,348.96 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $1,071.52 | Facility | None | $223.87 | $338.84 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $691.83 | Professional | None | $524.81 | $549.54 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Professional | None | $954.99 | $954.99 | $1,000.00 |
Security Health Setting Professional Modifier None Typical Low $912.01 Median $1,862.09 Typical High $2,041.74 | Professional | None | $912.01 | $1,862.09 | $2,041.74 |
The Alliance Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,778.28 | $1,778.28 | $2,187.76 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $1,412.54 | Professional | None | $302.00 | $630.96 | $1,412.54 |
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 $147.91 Median $147.91 Typical High $154.88 | Facility | 52 · Reduced service | $147.91 | $147.91 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $61.66 | Facility | 53 · Discontinued | $58.88 | $58.88 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $229.09 | Facility | 54 · Surgery only | $218.78 | $218.78 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $45.71 | Facility | 55 · Aftercare only | $43.65 | $43.65 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $30.90 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $213.80 | Facility | 78 · Unplanned return to OR | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $154.88 Typical High $1,202.26 | Professional | 52 · Reduced service | $147.91 | $154.88 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $478.63 | Professional | 53 · Discontinued | $58.88 | $61.66 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $1,778.28 | Professional | 54 · Surgery only | $218.78 | $229.09 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $354.81 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $239.88 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $1,659.59 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $323.59 Typical High $467.74 | Professional | 51 · Multiple procedures | $275.42 | $323.59 | $467.74 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $512.86 Typical High $741.31 | Professional | 54 · Surgery only | $436.52 | $512.86 | $741.31 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $186.21 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $186.21 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $776.25 |
Where Wisconsin sits
The same service costs 5.5 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
$776
AK $1,230TX $224
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.