How much rates vary
Facilitymedian $1,230 · 10th to 90th $288 to $3,802Professionalmedian $741 · 10th to 90th $324 to $2,239
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 $316.23 Median $338.84 Typical High $14,454.40 | Facility | None | $316.23 | $338.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $2,344.23 | Professional | None | $281.84 | $338.84 | $2,344.23 |
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 $323.59 Median $1,122.02 Typical High $2,344.23 | Professional | None | $323.59 | $1,122.02 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $1,659.59 Typical High $3,548.13 | Professional | 50 · Both sides | $478.63 | $1,659.59 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $1,230.27 | Facility | None | $229.09 | $630.96 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,479.11 | Professional | None | $501.19 | $616.60 | $1,479.11 |
DeanCare Setting Facility Modifier None Typical Low $331.13 Median $2,570.40 Typical High $4,786.30 | Facility | None | $331.13 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $954.99 | Professional | None | $537.03 | $691.83 | $954.99 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,047.13 Typical High $1,445.44 | Professional | 50 · Both sides | $812.83 | $1,047.13 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $912.01 Typical High $1,995.26 | Facility | None | $257.04 | $912.01 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $1,318.26 Typical High $2,570.40 | Professional | None | $354.81 | $1,318.26 | $2,570.40 |
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 $426.58 Median $794.33 Typical High $1,023.29 | Professional | None | $426.58 | $794.33 | $1,023.29 |
Prevea360 Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $645.65 | Facility | None | $295.12 | $380.19 | $645.65 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $1,380.38 | Professional | None | $537.03 | $912.01 | $1,380.38 |
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 $575.44 Median $616.60 Typical High $741.31 | Professional | None | $575.44 | $616.60 | $741.31 |
Security Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,023.29 | $1,096.48 |
Security Health Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $2,238.72 | Professional | None | $977.24 | $1,698.24 | $2,238.72 |
The Alliance Setting Professional Modifier None Typical Low $645.65 Median $1,513.56 Typical High $2,041.74 | Professional | None | $645.65 | $1,513.56 | $2,041.74 |
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 $323.59 Median $676.08 Typical High $1,548.82 | Professional | None | $323.59 | $676.08 | $1,548.82 |
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 $158.49 Median $158.49 Typical High $169.82 | Facility | 52 · Reduced service | $158.49 | $158.49 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $69.18 | Facility | 53 · Discontinued | $63.10 | $63.10 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $257.04 | Facility | 54 · Surgery only | $234.42 | $234.42 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $51.29 | Facility | 55 · Aftercare only | $46.77 | $46.77 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $33.88 | Facility | 56 · Pre-op care only | $31.62 | $31.62 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $169.82 Typical High $1,258.93 | Professional | 52 · Reduced service | $158.49 | $169.82 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $69.18 Typical High $501.19 | Professional | 53 · Discontinued | $63.10 | $69.18 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $1,905.46 | Professional | 54 · Surgery only | $234.42 | $257.04 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $380.19 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $251.19 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $239.88 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $218.78 | $239.88 | $1,778.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $346.74 Typical High $478.63 | Professional | 51 · Multiple procedures | $269.15 | $346.74 | $478.63 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $549.54 Typical High $776.25 | Professional | 54 · Surgery only | $436.52 | $549.54 | $776.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $190.55 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $190.55 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $812.83 |
Where Wisconsin sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$813
AK $1,288UT $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.