How much rates vary
Facilitymedian $1,202 · 10th to 90th $148 to $3,802Professionalmedian $224 · 10th to 90th $98 to $589
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 $77.62 Median $114.82 Typical High $14,454.40 | Facility | None | $77.62 | $114.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $1,096.48 | Professional | None | $77.62 | $114.82 | $1,096.48 |
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 $95.50 Median $295.12 Typical High $575.44 | Professional | None | $95.50 | $295.12 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $446.68 Typical High $870.96 | Professional | 50 · Both sides | $144.54 | $446.68 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $316.23 Typical High $812.83 | Facility | None | $151.36 | $316.23 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $537.03 | Professional | None | $131.83 | $208.93 | $537.03 |
DeanCare Setting Facility Modifier None Typical Low $91.20 Median $2,630.27 Typical High $5,128.61 | Facility | None | $91.20 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $309.03 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $316.23 Typical High $467.74 | Professional | 50 · Both sides | $218.78 | $316.23 | $467.74 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $812.83 Typical High $1,778.28 | Facility | None | $128.82 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $371.54 Typical High $870.96 | Professional | None | $114.82 | $371.54 | $870.96 |
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 $144.54 Median $229.09 Typical High $316.23 | Professional | None | $144.54 | $229.09 | $316.23 |
Prevea360 Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $199.53 | Facility | None | $75.86 | $123.03 | $199.53 |
Quartz Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $457.09 | Professional | None | $138.04 | $281.84 | $457.09 |
Quartz Setting Facility Modifier None Typical Low $147.91 Median $223.87 Typical High $1,479.11 | Facility | None | $147.91 | $223.87 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $245.47 | Professional | None | $141.25 | $208.93 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $380.19 | Professional | None | $251.19 | $251.19 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $758.58 | Professional | None | $269.15 | $501.19 | $758.58 |
The Alliance Setting Professional Modifier None Typical Low $213.80 Median $501.19 Typical High $707.95 | Professional | None | $213.80 | $501.19 | $707.95 |
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 $95.50 Median $173.78 Typical High $467.74 | Professional | None | $95.50 | $173.78 | $467.74 |
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 $38.90 Median $38.90 Typical High $57.54 | Facility | 52 · Reduced service | $38.90 | $38.90 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $22.91 | Facility | 53 · Discontinued | $15.49 | $15.49 | $22.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $87.10 | Facility | 54 · Surgery only | $57.54 | $57.54 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $17.38 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $11.48 | Facility | 56 · Pre-op care only | $7.76 | $7.76 | $11.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $53.70 Typical High $81.28 | Facility | 78 · Unplanned return to OR | $53.70 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $57.54 Typical High $549.54 | Professional | 52 · Reduced service | $38.90 | $57.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $22.91 Typical High $218.78 | Professional | 53 · Discontinued | $15.49 | $22.91 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $87.10 Typical High $812.83 | Professional | 54 · Surgery only | $57.54 | $87.10 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.38 Typical High $162.18 | Professional | 55 · Aftercare only | $11.48 | $17.38 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.48 Typical High $109.65 | Professional | 56 · Pre-op care only | $7.76 | $11.48 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $81.28 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $53.70 | $81.28 | $758.58 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $107.15 Typical High $154.88 | Professional | 51 · Multiple procedures | $72.44 | $107.15 | $154.88 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $251.19 | Professional | 54 · Surgery only | $114.82 | $169.82 | $251.19 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $42.66 Typical High $61.66 | Professional | 55 · Aftercare only | $28.84 | $42.66 | $61.66 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $177.83 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $123.03 | $177.83 | $263.03 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$251
AK $324KY $87.10
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.