How much rates vary
Facilitymedian $1,380 · 10th to 90th $288 to $3,802Professionalmedian $1,148 · 10th to 90th $525 to $3,388
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 $489.78 Median $524.81 Typical High $14,454.40 | Facility | None | $489.78 | $524.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $4,677.35 | Professional | None | $489.78 | $524.81 | $4,677.35 |
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 $489.78 Median $1,737.80 Typical High $3,630.78 | Professional | None | $489.78 | $1,737.80 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $2,570.40 Typical High $5,495.41 | Professional | 50 · Both sides | $741.31 | $2,570.40 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $1,659.59 | Facility | None | $229.09 | $630.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $2,290.87 | Professional | None | $776.25 | $933.25 | $2,290.87 |
DeanCare Setting Facility Modifier None Typical Low $549.54 Median $2,570.40 Typical High $4,786.30 | Facility | None | $549.54 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,548.82 | Professional | None | $912.01 | $1,096.48 | $1,548.82 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $2,344.23 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $954.99 Typical High $1,995.26 | Facility | None | $257.04 | $954.99 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,995.26 Typical High $3,890.45 | Professional | None | $549.54 | $1,995.26 | $3,890.45 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $1,548.82 | Professional | None | $660.69 | $1,174.90 | $1,548.82 |
Prevea360 Setting Facility Modifier None Typical Low $478.63 Median $588.84 Typical High $1,000.00 | Facility | None | $478.63 | $588.84 | $1,000.00 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,412.54 Typical High $2,137.96 | Professional | None | $794.33 | $1,412.54 | $2,137.96 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $1,071.52 | Facility | None | $223.87 | $338.84 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,122.02 | Professional | None | $870.96 | $933.25 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,584.89 | $1,584.89 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,691.53 | $3,467.37 |
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 $512.86 Median $1,071.52 Typical High $2,344.23 | Professional | None | $512.86 | $1,071.52 | $2,344.23 |
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 $245.47 Median $245.47 Typical High $263.03 | Facility | 52 · Reduced service | $245.47 | $245.47 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $104.71 | Facility | 53 · Discontinued | $97.72 | $97.72 | $104.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Facility | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $52.48 | Facility | 56 · Pre-op care only | $48.98 | $48.98 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $263.03 Typical High $2,344.23 | Professional | 52 · Reduced service | $245.47 | $263.03 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $933.25 | Professional | 53 · Discontinued | $97.72 | $104.71 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $3,467.37 | Professional | 54 · Surgery only | $363.08 | $389.05 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $691.83 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $467.74 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $3,235.94 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $549.54 Typical High $776.25 | Professional | 51 · Multiple procedures | $457.09 | $549.54 | $776.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | 54 · Surgery only | $724.44 | $870.96 | $1,258.93 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $218.78 Typical High $309.03 | Professional | 55 · Aftercare only | $181.97 | $218.78 | $309.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $912.01 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $776.25 | $912.01 | $1,318.26 |
Where Wisconsin sits
The same service costs 5.8 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
$1,175
AK $2,042TX $355
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.