How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,096 to $11,220Professionalmedian $1,622 · 10th to 90th $617 to $4,571
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 $616.60 Median $3,090.30 Typical High $14,454.40 | Facility | None | $616.60 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $6,165.95 | Professional | None | $616.60 | $616.60 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $2,238.72 Typical High $4,677.35 | Professional | None | $602.56 | $2,238.72 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $3,311.31 Typical High $6,918.31 | Professional | 50 · Both sides | $912.01 | $3,311.31 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,238.72 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,122.02 | $2,951.21 |
DeanCare Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $5,888.44 | Facility | None | $691.83 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,348.96 | $1,949.84 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,041.74 Typical High $2,951.21 | Professional | 50 · Both sides | $1,659.59 | $2,041.74 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $10,964.78 | Facility | None | $912.01 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,621.81 Typical High $4,677.35 | Professional | None | $676.08 | $1,621.81 | $4,677.35 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $1,905.46 | Professional | None | $776.25 | $1,479.11 | $1,905.46 |
Prevea360 Setting Facility Modifier None Typical Low $616.60 Median $691.83 Typical High $1,258.93 | Facility | None | $616.60 | $691.83 | $1,258.93 |
Quartz Setting Professional Modifier None Typical Low $660.69 Median $1,513.56 Typical High $2,691.53 | Professional | None | $660.69 | $1,513.56 | $2,691.53 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $4,570.88 | Facility | None | $724.44 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $4,365.16 | Professional | None | $1,905.46 | $3,090.30 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,288.25 Typical High $3,090.30 | Professional | None | $630.96 | $1,288.25 | $3,090.30 |
10 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 Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $3,090.30 | Professional | 52 · Reduced service | $309.03 | $309.03 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $1,230.27 | Professional | 53 · Discontinued | $123.03 | $123.03 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $4,677.35 | Professional | 54 · Surgery only | $467.74 | $467.74 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $933.25 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $616.60 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $4,365.16 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | 51 · Multiple procedures | $549.54 | $676.08 | $977.24 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | 54 · Surgery only | $891.25 | $1,096.48 | $1,584.89 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | 55 · Aftercare only | $223.87 | $275.42 | $389.05 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,148.15 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $933.25 | $1,148.15 | $1,659.59 |
Where Wisconsin sits
The same service costs 18.6 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
$2,138
AK $2,630TX $141
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.