How much rates vary
Facilitymedian $5,129 · 10th to 90th $692 to $9,120Professionalmedian $912 · 10th to 90th $398 to $2,630
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 $467.74 Typical High $14,454.40 | Facility | None | $316.23 | $467.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $3,388.44 | Professional | None | $316.23 | $467.74 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,202.26 Typical High $2,511.89 | Professional | None | $398.11 | $1,202.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $1,737.80 Typical High $3,630.78 | Professional | 50 · Both sides | $630.96 | $1,737.80 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $741.31 Typical High $1,513.56 | Professional | 62 · Two surgeons | $263.03 | $741.31 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,137.96 Typical High $4,168.69 | Facility | None | $954.99 | $2,137.96 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,949.84 | Professional | None | $575.44 | $851.14 | $1,949.84 |
DeanCare Setting Facility Modifier None Typical Low $436.52 Median $4,168.69 Typical High $7,413.10 | Facility | None | $436.52 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,174.90 | Professional | None | $562.34 | $812.83 | $1,174.90 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | 50 · Both sides | $851.14 | $1,202.26 | $1,778.28 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $501.19 Typical High $741.31 | Professional | 62 · Two surgeons | $354.81 | $501.19 | $741.31 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,951.21 Typical High $8,709.64 | Facility | None | $691.83 | $2,951.21 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,949.84 Typical High $3,548.13 | Professional | None | $549.54 | $1,949.84 | $3,548.13 |
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 $588.84 Median $977.24 Typical High $1,445.44 | Professional | None | $588.84 | $977.24 | $1,445.44 |
Prevea360 Setting Facility Modifier None Typical Low $316.23 Median $524.81 Typical High $812.83 | Facility | None | $316.23 | $524.81 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,071.52 Typical High $2,041.74 | Professional | None | $549.54 | $1,071.52 | $2,041.74 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $4,570.88 | Facility | None | $758.58 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,023.29 | Professional | None | $575.44 | $812.83 | $1,023.29 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,047.13 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,071.52 | $2,089.30 | $3,090.30 |
The Alliance Setting Professional Modifier None Typical Low $524.81 Median $1,479.11 Typical High $2,398.83 | Professional | None | $524.81 | $1,479.11 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $2,089.30 | Professional | None | $398.11 | $758.58 | $2,089.30 |
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 $234.42 | Facility | 52 · Reduced service | $158.49 | $158.49 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | 53 · Discontinued | $63.10 | $63.10 | $93.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $346.74 | Facility | 54 · Surgery only | $239.88 | $239.88 | $346.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $69.18 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $69.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $46.77 | Facility | 56 · Pre-op care only | $31.62 | $31.62 | $46.77 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $223.87 | $223.87 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $234.42 Typical High $1,778.28 | Professional | 52 · Reduced service | $158.49 | $234.42 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $93.33 Typical High $724.44 | Professional | 53 · Discontinued | $63.10 | $93.33 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $346.74 Typical High $2,691.53 | Professional | 54 · Surgery only | $239.88 | $346.74 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $69.18 Typical High $537.03 | Professional | 55 · Aftercare only | $47.86 | $69.18 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $46.77 Typical High $354.81 | Professional | 56 · Pre-op care only | $31.62 | $46.77 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $323.59 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $223.87 | $323.59 | $2,511.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $281.84 Median $398.11 Typical High $588.84 | Professional | 51 · Multiple procedures | $281.84 | $398.11 | $588.84 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $645.65 Typical High $933.25 | Professional | 54 · Surgery only | $457.09 | $645.65 | $933.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $162.18 Typical High $234.42 | Professional | 55 · Aftercare only | $112.20 | $162.18 | $234.42 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $676.08 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $478.63 | $676.08 | $1,000.00 |
Where Wisconsin sits
The same service costs 5.2 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,390MT $1,233
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.