How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,175 to $10,965Professionalmedian $2,344 · 10th to 90th $891 to $6,607
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 $891.25 Median $6,456.54 Typical High $14,454.40 | Facility | None | $891.25 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $7,244.36 | Professional | None | $891.25 | $891.25 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $3,548.13 Typical High $6,606.93 | Professional | None | $870.96 | $3,548.13 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $4,365.16 | Facility | None | $954.99 | $2,754.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $4,677.35 | Professional | None | $1,479.11 | $1,621.81 | $4,677.35 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,000.00 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,949.84 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,071.52 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,344.23 Typical High $6,760.83 | Professional | None | $912.01 | $2,344.23 | $6,760.83 |
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 $1,122.02 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,122.02 | $2,041.74 | $2,630.27 |
Prevea360 Setting Facility Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,737.80 | Facility | None | $912.01 | $1,000.00 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $3,981.07 | Professional | None | $1,000.00 | $2,290.87 | $3,981.07 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $4,570.88 | Facility | None | $758.58 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $6,456.54 | Professional | None | $2,754.23 | $4,168.69 | $6,456.54 |
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 $870.96 Median $1,862.09 Typical High $4,365.16 | Professional | None | $870.96 | $1,862.09 | $4,365.16 |
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 $446.68 Median $446.68 Typical High $3,630.78 | Professional | 52 · Reduced service | $446.68 | $446.68 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $1,445.44 | Professional | 53 · Discontinued | $177.83 | $177.83 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $5,495.41 | Professional | 54 · Surgery only | $676.08 | $676.08 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $1,096.48 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $724.44 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $5,128.61 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $977.24 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $794.33 | $977.24 | $1,412.54 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,584.89 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,288.25 | $1,584.89 | $2,238.72 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $389.05 Typical High $562.34 | Professional | 55 · Aftercare only | $316.23 | $389.05 | $562.34 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,659.59 | $2,398.83 |
Where Wisconsin sits
The same service costs 7.6 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
$3,020
AK $3,802TX $501
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.