How much rates vary
Facilitymedian $2,630 · 10th to 90th $603 to $5,754Professionalmedian $851 · 10th to 90th $389 to $2,344
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 $309.03 Median $446.68 Typical High $14,454.40 | Facility | None | $309.03 | $446.68 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $2,398.83 | Professional | None | $302.00 | $446.68 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $1,148.15 Typical High $2,344.23 | Professional | None | $426.58 | $1,148.15 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $1,737.80 Typical High $3,467.37 | Professional | 50 · Both sides | $645.65 | $1,737.80 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,187.76 | Facility | None | $977.24 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,905.46 | Professional | None | $549.54 | $812.83 | $1,905.46 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $3,090.30 Typical High $5,370.32 | Facility | None | $416.87 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,148.15 | Professional | None | $549.54 | $794.33 | $1,148.15 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,174.90 Typical High $1,698.24 | Professional | 50 · Both sides | $831.76 | $1,174.90 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $2,187.76 Typical High $4,786.30 | Facility | None | $549.54 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,905.46 Typical High $3,388.44 | Professional | None | $524.81 | $1,905.46 | $3,388.44 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,380.38 | Professional | None | $575.44 | $933.25 | $1,380.38 |
Prevea360 Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $812.83 | Facility | None | $309.03 | $501.19 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,949.84 | Professional | None | $537.03 | $1,047.13 | $1,949.84 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $2,187.76 | Facility | None | $724.44 | $1,380.38 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $977.24 | Professional | None | $562.34 | $776.25 | $977.24 |
Security Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,023.29 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,995.26 | $2,951.21 |
The Alliance Setting Professional Modifier None Typical Low $512.86 Median $1,819.70 Typical High $2,089.30 | Professional | None | $512.86 | $1,819.70 | $2,089.30 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $2,041.74 | Professional | None | $380.19 | $724.44 | $2,041.74 |
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 $154.88 Median $154.88 Typical High $223.87 | Facility | 52 · Reduced service | $154.88 | $154.88 | $223.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $91.20 | Facility | 53 · Discontinued | $61.66 | $61.66 | $91.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $338.84 | Facility | 54 · Surgery only | $234.42 | $234.42 | $338.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $67.61 | Facility | 55 · Aftercare only | $46.77 | $46.77 | $67.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $44.67 | Facility | 56 · Pre-op care only | $30.90 | $30.90 | $44.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $316.23 | Facility | 78 · Unplanned return to OR | $218.78 | $218.78 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $223.87 Typical High $1,318.26 | Professional | 52 · Reduced service | $154.88 | $223.87 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $91.20 Typical High $524.81 | Professional | 53 · Discontinued | $61.66 | $91.20 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $234.42 | $338.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $67.61 Typical High $389.05 | Professional | 55 · Aftercare only | $46.77 | $67.61 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $263.03 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $316.23 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $218.78 | $316.23 | $1,819.70 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $398.11 Typical High $575.44 | Professional | 51 · Multiple procedures | $275.42 | $398.11 | $575.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $630.96 Typical High $912.01 | Professional | 54 · Surgery only | $446.68 | $630.96 | $912.01 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $158.49 Typical High $229.09 | Professional | 55 · Aftercare only | $112.20 | $158.49 | $229.09 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $660.69 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $467.74 | $660.69 | $954.99 |
Where Wisconsin sits
The same service costs 4.9 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
$1,047
AK $1,413UT $288
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.