How much rates vary
Facilitymedian $1,259 · 10th to 90th $251 to $3,890Professionalmedian $646 · 10th to 90th $282 to $1,905
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 $302.00 Typical High $14,454.40 | Facility | None | $269.15 | $302.00 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $2,238.72 | Professional | None | $269.15 | $302.00 | $2,238.72 |
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 $269.15 Median $954.99 Typical High $1,949.84 | Professional | None | $269.15 | $954.99 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $1,380.38 Typical High $2,884.03 | Professional | 50 · Both sides | $407.38 | $1,380.38 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $954.99 | Facility | None | $50.12 | $338.84 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,258.93 | Professional | None | $436.52 | $537.03 | $1,258.93 |
DeanCare Setting Facility Modifier None Typical Low $302.00 Median $2,630.27 Typical High $5,128.61 | Facility | None | $302.00 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $812.83 | Professional | None | $501.19 | $630.96 | $812.83 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $1,230.27 | Professional | 50 · Both sides | $758.58 | $954.99 | $1,230.27 |
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 $295.12 Median $1,122.02 Typical High $2,238.72 | Professional | None | $295.12 | $1,122.02 | $2,238.72 |
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 $380.19 Median $645.65 Typical High $831.76 | Professional | None | $380.19 | $645.65 | $831.76 |
Prevea360 Setting Facility Modifier None Typical Low $263.03 Median $338.84 Typical High $562.34 | Facility | None | $263.03 | $338.84 | $562.34 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $1,148.15 | Professional | None | $457.09 | $794.33 | $1,148.15 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $371.54 | Facility | None | $50.12 | $245.47 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $645.65 | Professional | None | $478.63 | $537.03 | $645.65 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $954.99 | Professional | None | $851.14 | $851.14 | $954.99 |
Security Health Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,949.84 | Professional | None | $812.83 | $1,445.44 | $1,949.84 |
The Alliance Setting Professional Modifier None Typical Low $575.44 Median $1,288.25 Typical High $1,905.46 | Professional | None | $575.44 | $1,288.25 | $1,905.46 |
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 $575.44 Typical High $1,318.26 | Professional | None | $269.15 | $575.44 | $1,318.26 |
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 $147.91 | Facility | 52 · Reduced service | $131.83 | $131.83 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $60.26 | Facility | 53 · Discontinued | $53.70 | $53.70 | $60.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $223.87 | Facility | 54 · Surgery only | $199.53 | $199.53 | $223.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $44.67 | Facility | 55 · Aftercare only | $39.81 | $39.81 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $30.20 | Facility | 56 · Pre-op care only | $26.92 | $26.92 | $30.20 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | 78 · Unplanned return to OR | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $147.91 Typical High $1,096.48 | Professional | 52 · Reduced service | $131.83 | $147.91 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $446.68 | Professional | 53 · Discontinued | $53.70 | $60.26 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $223.87 Typical High $1,659.59 | Professional | 54 · Surgery only | $199.53 | $223.87 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $331.13 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $223.87 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $1,548.82 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $316.23 Typical High $407.38 | Professional | 51 · Multiple procedures | $251.19 | $316.23 | $407.38 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $398.11 | $501.19 | $660.69 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $100.00 | $125.89 | $162.18 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $691.83 |
Where Wisconsin sits
The same service costs 5.4 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 $204
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.