How much rates vary
Facilitymedian $2,399 · 10th to 90th $309 to $5,623Professionalmedian $490 · 10th to 90th $219 to $1,288
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 $162.18 Median $251.19 Typical High $14,454.40 | Facility | None | $162.18 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $1,348.96 | Professional | None | $162.18 | $251.19 | $1,348.96 |
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 $218.78 Median $602.56 Typical High $1,230.27 | Professional | None | $218.78 | $602.56 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $891.25 Typical High $1,819.70 | Professional | 50 · Both sides | $331.13 | $891.25 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $1,071.52 | Facility | None | $309.03 | $616.60 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $1,071.52 | Professional | None | $288.40 | $457.09 | $1,071.52 |
DeanCare Setting Facility Modifier None Typical Low $181.97 Median $2,630.27 Typical High $5,128.61 | Facility | None | $181.97 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $676.08 | Professional | None | $302.00 | $457.09 | $676.08 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $691.83 Typical High $1,023.29 | Professional | 50 · Both sides | $457.09 | $691.83 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $2,041.74 Typical High $4,365.16 | Facility | None | $302.00 | $2,041.74 | $4,365.16 |
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 $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 $323.59 Median $512.86 Typical High $724.44 | Professional | None | $323.59 | $512.86 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $141.25 Median $257.04 Typical High $501.19 | Facility | None | $141.25 | $257.04 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $1,047.13 | Professional | None | $288.40 | $602.56 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $1,071.52 | Facility | None | $302.00 | $426.58 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $549.54 | Professional | None | $288.40 | $457.09 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $870.96 | Professional | None | $537.03 | $537.03 | $870.96 |
Security Health Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $1,659.59 | Professional | None | $549.54 | $1,047.13 | $1,659.59 |
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 $194.98 Median $389.05 Typical High $1,096.48 | Professional | None | $194.98 | $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 $79.43 Median $79.43 Typical High $125.89 | Facility | 52 · Reduced service | $79.43 | $79.43 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $51.29 | Facility | 53 · Discontinued | $32.36 | $32.36 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $190.55 | Facility | 54 · Surgery only | $120.23 | $120.23 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $38.02 | Facility | 55 · Aftercare only | $23.99 | $23.99 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $25.12 | Facility | 56 · Pre-op care only | $16.22 | $16.22 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $112.20 Typical High $177.83 | Facility | 78 · Unplanned return to OR | $112.20 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $125.89 Typical High $660.69 | Professional | 52 · Reduced service | $79.43 | $125.89 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $51.29 Typical High $269.15 | Professional | 53 · Discontinued | $32.36 | $51.29 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $190.55 Typical High $1,000.00 | Professional | 54 · Surgery only | $120.23 | $190.55 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.02 Typical High $199.53 | Professional | 55 · Aftercare only | $23.99 | $38.02 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $25.12 Typical High $134.90 | Professional | 56 · Pre-op care only | $16.22 | $25.12 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $177.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $112.20 | $177.83 | $933.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $151.36 Median $229.09 Typical High $338.84 | Professional | 51 · Multiple procedures | $151.36 | $229.09 | $338.84 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $363.08 Typical High $549.54 | Professional | 54 · Surgery only | $239.88 | $363.08 | $549.54 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $91.20 Typical High $134.90 | Professional | 55 · Aftercare only | $60.26 | $91.20 | $134.90 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $575.44 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Utah. 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
$575
AK $692UT $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.