How much rates vary
Facilitymedian $2,291 · 10th to 90th $550 to $5,754Professionalmedian $1,000 · 10th to 90th $457 to $2,754
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 $363.08 Median $512.86 Typical High $14,454.40 | Facility | None | $363.08 | $512.86 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $3,388.44 | Professional | None | $354.81 | $501.19 | $3,388.44 |
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 $501.19 Median $1,348.96 Typical High $2,754.23 | Professional | None | $501.19 | $1,348.96 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,995.26 Typical High $4,073.80 | Professional | 50 · Both sides | $741.31 | $1,995.26 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,290.87 | Facility | None | $1,071.52 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $2,137.96 | Professional | None | $630.96 | $933.25 | $2,137.96 |
DeanCare Setting Facility Modifier None Typical Low $478.63 Median $4,786.30 Typical High $8,912.51 | Facility | None | $478.63 | $4,786.30 | $8,912.51 |
DeanCare Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,288.25 | Professional | None | $645.65 | $912.01 | $1,288.25 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,380.38 Typical High $1,949.84 | Professional | 50 · Both sides | $977.24 | $1,380.38 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,548.82 Typical High $3,981.07 | Facility | None | $446.68 | $1,548.82 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $2,137.96 Typical High $3,890.45 | Professional | None | $588.84 | $2,137.96 | $3,890.45 |
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 $645.65 Median $1,122.02 Typical High $1,584.89 | Professional | None | $645.65 | $1,122.02 | $1,584.89 |
Prevea360 Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $831.76 | Facility | None | $363.08 | $588.84 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $2,187.76 | Professional | None | $630.96 | $1,174.90 | $2,187.76 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,290.87 | Facility | None | $933.25 | $1,412.54 | $2,290.87 |
Quartz Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,122.02 | Professional | None | $660.69 | $870.96 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,202.26 | $1,737.80 |
Security Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,230.27 | $2,398.83 | $3,388.44 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
United Setting Professional Modifier None Typical Low $436.52 Median $851.14 Typical High $2,398.83 | Professional | None | $436.52 | $851.14 | $2,398.83 |
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 $181.97 Median $181.97 Typical High $257.04 | Facility | 52 · Reduced service | $181.97 | $181.97 | $257.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $102.33 | Facility | 53 · Discontinued | $72.44 | $72.44 | $102.33 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $380.19 | Facility | 54 · Surgery only | $275.42 | $275.42 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $77.62 | Facility | 55 · Aftercare only | $54.95 | $54.95 | $77.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $51.29 | Facility | 56 · Pre-op care only | $36.31 | $36.31 | $51.29 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $257.04 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $257.04 Typical High $1,778.28 | Professional | 52 · Reduced service | $181.97 | $257.04 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $102.33 Typical High $724.44 | Professional | 53 · Discontinued | $72.44 | $102.33 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $380.19 Typical High $2,691.53 | Professional | 54 · Surgery only | $275.42 | $380.19 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $537.03 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $51.29 Typical High $363.08 | Professional | 56 · Pre-op care only | $36.31 | $51.29 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $2,511.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $457.09 Typical High $645.65 | Professional | 51 · Multiple procedures | $323.59 | $457.09 | $645.65 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $741.31 Typical High $1,047.13 | Professional | 54 · Surgery only | $524.81 | $741.31 | $1,047.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $181.97 Typical High $257.04 | Professional | 55 · Aftercare only | $131.83 | $181.97 | $257.04 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $776.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $549.54 | $776.25 | $1,096.48 |
Where Wisconsin sits
The same service costs 4.8 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
$1,175
AK $1,549UT $324
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.