How much rates vary
Facilitymedian $1,995 · 10th to 90th $275 to $4,266Professionalmedian $427 · 10th to 90th $178 to $1,148
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 $131.83 Median $234.42 Typical High $14,454.40 | Facility | None | $131.83 | $234.42 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $1,174.90 | Professional | None | $128.82 | $223.87 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $489.78 Typical High $1,000.00 | Professional | None | $181.97 | $489.78 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $724.44 Typical High $1,479.11 | Professional | 50 · Both sides | $269.15 | $724.44 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $562.34 Typical High $1,071.52 | Facility | None | $281.84 | $562.34 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $1,000.00 | Professional | None | $239.88 | $426.58 | $1,000.00 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $2,570.40 Typical High $4,786.30 | Facility | None | $208.93 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $588.84 | Professional | None | $234.42 | $371.54 | $588.84 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $562.34 Typical High $891.25 | Professional | 50 · Both sides | $354.81 | $562.34 | $891.25 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $1,479.11 Typical High $3,019.95 | Facility | None | $275.42 | $1,479.11 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $1,000.00 Typical High $1,862.09 | Professional | None | $269.15 | $1,000.00 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $724.44 | Professional | None | $295.12 | $467.74 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $263.03 Typical High $489.78 | Facility | None | $131.83 | $263.03 | $489.78 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $549.54 Typical High $1,047.13 | Professional | None | $263.03 | $549.54 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $275.42 Median $416.87 Typical High $1,071.52 | Facility | None | $275.42 | $416.87 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $512.86 | Professional | None | $239.88 | $426.58 | $512.86 |
Security Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $812.83 | Professional | None | $436.52 | $436.52 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $1,584.89 | Professional | None | $446.68 | $851.14 | $1,584.89 |
The Alliance Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $1,513.56 | Professional | None | $389.05 | $758.58 | $1,513.56 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $162.18 Median $380.19 Typical High $1,096.48 | Professional | None | $162.18 | $380.19 | $1,096.48 |
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 $66.07 Median $66.07 Typical High $117.49 | Facility | 52 · Reduced service | $66.07 | $66.07 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $46.77 | Facility | 53 · Discontinued | $26.30 | $26.30 | $46.77 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $173.78 | Facility | 54 · Surgery only | $100.00 | $100.00 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $35.48 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $23.44 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $23.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $162.18 | Facility | 78 · Unplanned return to OR | $93.33 | $93.33 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $117.49 Typical High $676.08 | Professional | 52 · Reduced service | $66.07 | $117.49 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $46.77 Typical High $269.15 | Professional | 53 · Discontinued | $26.30 | $46.77 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $173.78 Typical High $1,000.00 | Professional | 54 · Surgery only | $100.00 | $173.78 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $35.48 Typical High $199.53 | Professional | 55 · Aftercare only | $19.95 | $35.48 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $23.44 Typical High $134.90 | Professional | 56 · Pre-op care only | $13.18 | $23.44 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $162.18 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $93.33 | $162.18 | $933.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $186.21 Typical High $295.12 | Professional | 51 · Multiple procedures | $117.49 | $186.21 | $295.12 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $295.12 Typical High $478.63 | Professional | 54 · Surgery only | $186.21 | $295.12 | $478.63 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $74.13 Typical High $117.49 | Professional | 55 · Aftercare only | $46.77 | $74.13 | $117.49 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $309.03 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $199.53 | $309.03 | $501.19 |
Where Wisconsin sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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
$479
AK $617KY $170
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.