How much rates vary
Facilitymedian $1,230 · 10th to 90th $282 to $3,802Professionalmedian $692 · 10th to 90th $302 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 $323.59 Typical High $14,454.40 | Facility | None | $295.12 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $1,949.84 | Professional | None | $281.84 | $323.59 | $1,949.84 |
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 $302.00 Median $1,047.13 Typical High $2,187.76 | Professional | None | $302.00 | $1,047.13 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $1,548.82 Typical High $3,311.31 | Professional | 50 · Both sides | $457.09 | $1,548.82 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $1,148.15 | Facility | None | $229.09 | $630.96 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,380.38 | Professional | None | $478.63 | $575.44 | $1,380.38 |
DeanCare Setting Facility Modifier None Typical Low $323.59 Median $2,570.40 Typical High $4,786.30 | Facility | None | $323.59 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $891.25 | Professional | None | $501.19 | $645.65 | $891.25 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $954.99 Typical High $1,348.96 | Professional | 50 · Both sides | $758.58 | $954.99 | $1,348.96 |
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 $338.84 Median $1,230.27 Typical High $2,398.83 | Professional | None | $338.84 | $1,230.27 | $2,398.83 |
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 $407.38 Median $741.31 Typical High $977.24 | Professional | None | $407.38 | $741.31 | $977.24 |
Prevea360 Setting Facility Modifier None Typical Low $275.42 Median $354.81 Typical High $616.60 | Facility | None | $275.42 | $354.81 | $616.60 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $851.14 Typical High $1,288.25 | Professional | None | $489.78 | $851.14 | $1,288.25 |
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 $524.81 Median $575.44 Typical High $691.83 | Professional | None | $524.81 | $575.44 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | None | $954.99 | $954.99 | $1,047.13 |
Security Health Setting Professional Modifier None Typical Low $912.01 Median $1,621.81 Typical High $2,137.96 | Professional | None | $912.01 | $1,621.81 | $2,137.96 |
The Alliance Setting Professional Modifier None Typical Low $501.19 Median $1,288.25 Typical High $1,905.46 | Professional | None | $501.19 | $1,288.25 | $1,905.46 |
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 $309.03 Median $645.65 Typical High $1,445.44 | Professional | None | $309.03 | $645.65 | $1,445.44 |
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 $144.54 Median $144.54 Typical High $158.49 | Facility | 52 · Reduced service | $144.54 | $144.54 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $64.57 | Facility | 53 · Discontinued | $58.88 | $58.88 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $239.88 | Facility | 54 · Surgery only | $218.78 | $218.78 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $47.86 | Facility | 55 · Aftercare only | $43.65 | $43.65 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $32.36 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $158.49 Typical High $1,122.02 | Professional | 52 · Reduced service | $144.54 | $158.49 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $457.09 | Professional | 53 · Discontinued | $58.88 | $64.57 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $239.88 Typical High $1,698.24 | Professional | 54 · Surgery only | $218.78 | $239.88 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $338.84 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $229.09 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $223.87 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $204.17 | $223.87 | $1,584.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $323.59 Typical High $446.68 | Professional | 51 · Multiple procedures | $251.19 | $323.59 | $446.68 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $407.38 | $512.86 | $724.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $128.82 Typical High $181.97 | Professional | 55 · Aftercare only | $102.33 | $128.82 | $181.97 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $758.58 |
Where Wisconsin sits
The same service costs 5.5 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
$741
AK $1,202UT $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.