How much rates vary
Facilitymedian $1,202 · 10th to 90th $251 to $3,802Professionalmedian $692 · 10th to 90th $295 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 $309.03 Typical High $14,454.40 | Facility | None | $295.12 | $309.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $1,862.09 | Professional | None | $295.12 | $309.03 | $1,862.09 |
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 $281.84 Median $1,122.02 Typical High $2,137.96 | Professional | None | $281.84 | $1,122.02 | $2,137.96 |
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 $457.09 Median $562.34 Typical High $1,548.82 | Professional | None | $457.09 | $562.34 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $288.40 Median $2,630.27 Typical High $5,128.61 | Facility | None | $288.40 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $891.25 | Professional | None | $562.34 | $660.69 | $891.25 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,174.90 Typical High $2,344.23 | Professional | None | $309.03 | $1,174.90 | $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 $389.05 Median $691.83 Typical High $891.25 | Professional | None | $389.05 | $691.83 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $616.60 | Facility | None | $239.88 | $346.74 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $1,348.96 | Professional | None | $501.19 | $851.14 | $1,348.96 |
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 $537.03 Median $562.34 Typical High $676.08 | Professional | None | $537.03 | $562.34 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | None | $933.25 | $933.25 | $1,000.00 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,041.74 | Professional | None | $891.25 | $1,584.89 | $2,041.74 |
The Alliance Setting Professional Modifier None Typical Low $588.84 Median $1,380.38 Typical High $1,862.09 | Professional | None | $588.84 | $1,380.38 | $1,862.09 |
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 $288.40 Median $602.56 Typical High $1,380.38 | Professional | None | $288.40 | $602.56 | $1,380.38 |
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 $147.91 Median $147.91 Typical High $154.88 | Facility | 52 · Reduced service | $147.91 | $147.91 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $61.66 | Facility | 53 · Discontinued | $58.88 | $58.88 | $61.66 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $234.42 | Facility | 54 · Surgery only | $223.87 | $223.87 | $234.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $46.77 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $30.90 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $30.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $218.78 | Facility | 78 · Unplanned return to OR | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $154.88 Typical High $1,000.00 | Professional | 52 · Reduced service | $147.91 | $154.88 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $398.11 | Professional | 53 · Discontinued | $58.88 | $61.66 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $234.42 Typical High $1,479.11 | Professional | 54 · Surgery only | $223.87 | $234.42 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $295.12 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $199.53 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $218.78 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $208.93 | $218.78 | $1,380.38 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $323.59 Typical High $446.68 | Professional | 51 · Multiple procedures | $275.42 | $323.59 | $446.68 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $724.44 | Professional | 54 · Surgery only | $446.68 | $524.81 | $724.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $181.97 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $181.97 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $758.58 |
Where Wisconsin sits
The same service costs 5.6 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
$759
AK $1,230TX $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.