How much rates vary
Facilitymedian $1,202 · 10th to 90th $257 to $3,802Professionalmedian $692 · 10th to 90th $302 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 $316.23 Typical High $14,454.40 | Facility | None | $295.12 | $316.23 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $2,454.71 | Professional | None | $295.12 | $316.23 | $2,454.71 |
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 $1,023.29 Typical High $2,137.96 | Professional | None | $295.12 | $1,023.29 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $1,513.56 Typical High $3,235.94 | Professional | 50 · Both sides | $436.52 | $1,513.56 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $1,000.00 | Facility | None | $50.12 | $338.84 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,380.38 | Professional | None | $478.63 | $575.44 | $1,380.38 |
DeanCare Setting Facility Modifier None Typical Low $323.59 Median $2,630.27 Typical High $5,128.61 | Facility | None | $323.59 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | None | $549.54 | $660.69 | $912.01 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $1,348.96 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $1,348.96 |
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 $323.59 Median $1,202.26 Typical High $2,344.23 | Professional | None | $323.59 | $1,202.26 | $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 $398.11 Median $707.95 Typical High $933.25 | Professional | None | $398.11 | $707.95 | $933.25 |
Prevea360 Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $616.60 | Facility | None | $288.40 | $354.81 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $1,258.93 | Professional | None | $489.78 | $851.14 | $1,258.93 |
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 $524.81 Median $575.44 Typical High $691.83 | Professional | None | $524.81 | $575.44 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | None | $933.25 | $933.25 | $1,023.29 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,089.30 | Professional | None | $891.25 | $1,584.89 | $2,089.30 |
The Alliance Setting Professional Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,137.96 | Professional | None | $602.56 | $1,412.54 | $2,137.96 |
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 $295.12 Median $616.60 Typical High $1,412.54 | Professional | None | $295.12 | $616.60 | $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 $144.54 Median $144.54 Typical High $158.49 | Facility | 52 · Reduced service | $144.54 | $144.54 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $63.10 | Facility | 53 · Discontinued | $58.88 | $58.88 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $239.88 | Facility | 54 · Surgery only | $218.78 | $218.78 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $47.86 | Facility | 55 · Aftercare only | $43.65 | $43.65 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $31.62 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $31.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $158.49 Typical High $1,230.27 | Professional | 52 · Reduced service | $144.54 | $158.49 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $489.78 | Professional | 53 · Discontinued | $58.88 | $63.10 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $1,819.70 | Professional | 54 · Surgery only | $218.78 | $239.88 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $363.08 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $245.47 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $1,698.24 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $331.13 Typical High $457.09 | Professional | 51 · Multiple procedures | $275.42 | $331.13 | $457.09 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $537.03 Typical High $724.44 | Professional | 54 · Surgery only | $436.52 | $537.03 | $724.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $134.90 Typical High $181.97 | Professional | 55 · Aftercare only | $109.65 | $134.90 | $181.97 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $457.09 | $562.34 | $758.58 |
Where Wisconsin sits
The same service costs 5.5 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
$759
AK $1,202UT $219
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.