How much rates vary
Facilitymedian $1,202 · 10th to 90th $269 to $3,802Professionalmedian $631 · 10th to 90th $275 to $1,862
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 $269.15 Median $275.42 Typical High $14,454.40 | Facility | None | $269.15 | $275.42 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $2,137.96 | Professional | None | $269.15 | $275.42 | $2,137.96 |
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 $257.04 Median $954.99 Typical High $1,995.26 | Professional | None | $257.04 | $954.99 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $1,380.38 Typical High $2,951.21 | Professional | 50 · Both sides | $389.05 | $1,380.38 | $2,951.21 |
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 $426.58 Median $501.19 Typical High $1,258.93 | Professional | None | $426.58 | $501.19 | $1,258.93 |
DeanCare Setting Facility Modifier None Typical Low $275.42 Median $2,570.40 Typical High $4,786.30 | Facility | None | $275.42 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $831.76 | Professional | None | $501.19 | $588.84 | $831.76 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $870.96 Typical High $1,258.93 | Professional | 50 · Both sides | $741.31 | $870.96 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $912.01 Typical High $1,778.28 | Facility | None | $218.78 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,047.13 Typical High $2,089.30 | Professional | None | $281.84 | $1,047.13 | $2,089.30 |
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 $354.81 Median $630.96 Typical High $831.76 | Professional | None | $354.81 | $630.96 | $831.76 |
Prevea360 Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $575.44 | Facility | None | $251.19 | $309.03 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $1,148.15 | Professional | None | $457.09 | $776.25 | $1,148.15 |
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 $478.63 Median $501.19 Typical High $616.60 | Professional | None | $478.63 | $501.19 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | None | $851.14 | $851.14 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $1,819.70 | Professional | None | $831.76 | $1,445.44 | $1,819.70 |
The Alliance Setting Professional Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,737.80 | Professional | None | $537.03 | $1,258.93 | $1,737.80 |
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 $269.15 Median $562.34 Typical High $1,258.93 | Professional | None | $269.15 | $562.34 | $1,258.93 |
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 $138.04 | Facility | 52 · Reduced service | $131.83 | $131.83 | $138.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $56.23 | Facility | 53 · Discontinued | $53.70 | $53.70 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $208.93 | Facility | 54 · Surgery only | $199.53 | $199.53 | $208.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $41.69 | Facility | 55 · Aftercare only | $39.81 | $39.81 | $41.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $27.54 | Facility | 56 · Pre-op care only | $26.92 | $26.92 | $27.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $194.98 | Facility | 78 · Unplanned return to OR | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $138.04 Typical High $1,071.52 | Professional | 52 · Reduced service | $131.83 | $138.04 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $426.58 | Professional | 53 · Discontinued | $53.70 | $56.23 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $208.93 Typical High $1,621.81 | Professional | 54 · Surgery only | $199.53 | $208.93 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $323.59 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $27.54 Typical High $213.80 | Professional | 56 · Pre-op care only | $26.92 | $27.54 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $194.98 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $186.21 | $194.98 | $1,513.56 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $295.12 Typical High $416.87 | Professional | 51 · Multiple procedures | $251.19 | $295.12 | $416.87 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $467.74 Typical High $660.69 | Professional | 54 · Surgery only | $398.11 | $467.74 | $660.69 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $165.96 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $165.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $691.83 |
Where Wisconsin sits
The same service costs 5.9 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
$708
AK $1,096TX $186
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.