How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,148 to $18,621Professionalmedian $1,549 · 10th to 90th $589 to $4,467
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 $588.84 Median $6,456.54 Typical High $14,454.40 | Facility | None | $588.84 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $5,888.44 | Professional | None | $588.84 | $588.84 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $14,454.40 Typical High $22,387.21 | Facility | None | $5,888.44 | $14,454.40 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $2,290.87 Typical High $4,466.84 | Professional | None | $575.44 | $2,290.87 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,691.53 Typical High $9,332.54 | Facility | None | $954.99 | $2,691.53 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $3,090.30 | Professional | None | $977.24 | $1,071.52 | $3,090.30 |
DeanCare Setting Facility Modifier None Typical Low $707.95 Median $4,365.16 Typical High $7,762.47 | Facility | None | $707.95 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,318.26 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $13,803.84 | Facility | None | $912.01 | $5,623.41 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,621.81 Typical High $5,248.07 | Professional | None | $645.65 | $1,621.81 | $5,248.07 |
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 $758.58 Median $1,412.54 Typical High $1,819.70 | Professional | None | $758.58 | $1,412.54 | $1,819.70 |
Prevea360 Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Facility | None | $588.84 | $812.83 | $1,202.26 |
Quartz Setting Professional Modifier None Typical Low $645.65 Median $1,479.11 Typical High $2,754.23 | Professional | None | $645.65 | $1,479.11 | $2,754.23 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,232.93 | Facility | None | $758.58 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $4,168.69 | Professional | None | $1,862.09 | $3,090.30 | $4,168.69 |
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 $1,230.27 Typical High $2,951.21 | Professional | None | $630.96 | $1,230.27 | $2,951.21 |
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 $295.12 Median $295.12 Typical High $2,951.21 | Professional | 52 · Reduced service | $295.12 | $295.12 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $1,174.90 | Professional | 53 · Discontinued | $120.23 | $120.23 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $4,365.16 | Professional | 54 · Surgery only | $446.68 | $446.68 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $870.96 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $588.84 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $4,073.80 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $645.65 Typical High $933.25 | Professional | 51 · Multiple procedures | $524.81 | $645.65 | $933.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,513.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | 55 · Aftercare only | $213.80 | $263.03 | $380.19 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $1,584.89 |
Where Wisconsin sits
The same service costs 8.1 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 $2,512TX $309
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.