How much rates vary
Facilitymedian $3,311 · 10th to 90th $631 to $7,762Professionalmedian $692 · 10th to 90th $316 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 $281.84 Median $316.23 Typical High $14,454.40 | Facility | None | $281.84 | $316.23 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $2,187.76 | Professional | None | $269.15 | $316.23 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $1,023.29 Typical High $2,137.96 | Professional | None | $316.23 | $1,023.29 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,398.83 | Facility | None | $851.14 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,318.26 | Professional | None | $489.78 | $575.44 | $1,318.26 |
DeanCare Setting Facility Modifier None Typical Low $316.23 Median $3,090.30 Typical High $5,370.32 | Facility | None | $316.23 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $891.25 | Professional | None | $501.19 | $616.60 | $891.25 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $2,951.21 Typical High $8,317.64 | Facility | None | $575.44 | $2,951.21 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,258.93 Typical High $3,090.30 | Professional | None | $363.08 | $1,258.93 | $3,090.30 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $398.11 Median $794.33 Typical High $977.24 | Professional | None | $398.11 | $794.33 | $977.24 |
Prevea360 Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $630.96 | Facility | None | $275.42 | $380.19 | $630.96 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $812.83 Typical High $1,318.26 | Professional | None | $446.68 | $812.83 | $1,318.26 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,584.89 Typical High $2,691.53 | Facility | None | $758.58 | $1,584.89 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $691.83 | Professional | None | $512.86 | $575.44 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | None | $912.01 | $912.01 | $1,023.29 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,137.96 | Professional | None | $954.99 | $1,659.59 | $2,137.96 |
The Alliance Setting Professional Modifier None Typical Low $467.74 Median $912.01 Typical High $1,513.56 | Professional | None | $467.74 | $912.01 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,677.35 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,677.35 | $8,709.64 |
United Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $1,513.56 | Professional | None | $323.59 | $645.65 | $1,513.56 |
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 $141.25 Median $141.25 Typical High $158.49 | Facility | 52 · Reduced service | $141.25 | $141.25 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $63.10 | Facility | 53 · Discontinued | $56.23 | $56.23 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $239.88 | Facility | 54 · Surgery only | $213.80 | $213.80 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $47.86 | Facility | 55 · Aftercare only | $42.66 | $42.66 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $31.62 | Facility | 56 · Pre-op care only | $28.18 | $28.18 | $31.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $158.49 Typical High $1,174.90 | Professional | 52 · Reduced service | $141.25 | $158.49 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $467.74 | Professional | 53 · Discontinued | $56.23 | $63.10 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $1,778.28 | Professional | 54 · Surgery only | $213.80 | $239.88 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $354.81 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $31.62 Typical High $234.42 | Professional | 56 · Pre-op care only | $28.18 | $31.62 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $1,659.59 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | 51 · Multiple procedures | $251.19 | $309.03 | $446.68 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 54 · Surgery only | $398.11 | $489.78 | $707.95 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $177.83 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $177.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $524.81 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $416.87 | $524.81 | $741.31 |
Where Wisconsin sits
The same service costs 6.8 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
$832
AK $1,288UT $191
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.