How much rates vary
Facilitymedian $3,020 · 10th to 90th $501 to $7,762Professionalmedian $871 · 10th to 90th $407 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 $302.00 Median $436.52 Typical High $14,454.40 | Facility | None | $302.00 | $436.52 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $2,630.27 | Professional | None | $302.00 | $436.52 | $2,630.27 |
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 $416.87 Median $1,122.02 Typical High $2,290.87 | Professional | None | $416.87 | $1,122.02 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $1,659.59 Typical High $3,467.37 | Professional | 50 · Both sides | $630.96 | $1,659.59 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $870.96 Typical High $1,584.89 | Facility | None | $467.74 | $870.96 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,862.09 | Professional | None | $537.03 | $794.33 | $1,862.09 |
DeanCare Setting Facility Modifier None Typical Low $363.08 Median $2,630.27 Typical High $5,128.61 | Facility | None | $363.08 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,122.02 | Professional | None | $549.54 | $776.25 | $1,122.02 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,148.15 Typical High $1,659.59 | Professional | 50 · Both sides | $812.83 | $1,148.15 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $2,511.89 Typical High $8,128.31 | Facility | None | $524.81 | $2,511.89 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,819.70 Typical High $3,388.44 | Professional | None | $489.78 | $1,819.70 | $3,388.44 |
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 $549.54 Median $891.25 Typical High $1,318.26 | Professional | None | $549.54 | $891.25 | $1,318.26 |
Prevea360 Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $891.25 | Facility | None | $302.00 | $489.78 | $891.25 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $1,023.29 Typical High $1,862.09 | Professional | None | $537.03 | $1,023.29 | $1,862.09 |
Quartz Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $1,479.11 | Facility | None | $467.74 | $707.95 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $954.99 | Professional | None | $549.54 | $794.33 | $954.99 |
Security Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,000.00 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,995.26 | $2,884.03 |
The Alliance Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $363.08 Median $707.95 Typical High $1,949.84 | Professional | None | $363.08 | $707.95 | $1,949.84 |
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 $151.36 Median $151.36 Typical High $218.78 | Facility | 52 · Reduced service | $151.36 | $151.36 | $218.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $89.13 | Facility | 53 · Discontinued | $61.66 | $61.66 | $89.13 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $331.13 | Facility | 54 · Surgery only | $229.09 | $229.09 | $331.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $66.07 | Facility | 55 · Aftercare only | $45.71 | $45.71 | $66.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $43.65 | Facility | 56 · Pre-op care only | $30.20 | $30.20 | $43.65 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $309.03 | Facility | 78 · Unplanned return to OR | $213.80 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $218.78 Typical High $1,318.26 | Professional | 52 · Reduced service | $151.36 | $218.78 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $524.81 | Professional | 53 · Discontinued | $61.66 | $89.13 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $331.13 Typical High $1,949.84 | Professional | 54 · Surgery only | $229.09 | $331.13 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $66.07 Typical High $389.05 | Professional | 55 · Aftercare only | $45.71 | $66.07 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $43.65 Typical High $263.03 | Professional | 56 · Pre-op care only | $30.20 | $43.65 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $309.03 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $213.80 | $309.03 | $1,819.70 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $275.42 Median $389.05 Typical High $562.34 | Professional | 51 · Multiple procedures | $275.42 | $389.05 | $562.34 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $616.60 Typical High $891.25 | Professional | 54 · Surgery only | $436.52 | $616.60 | $891.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $154.88 Typical High $223.87 | Professional | 55 · Aftercare only | $109.65 | $154.88 | $223.87 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $645.65 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $457.09 | $645.65 | $933.25 |
Where Wisconsin sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$1,000
AK $1,259TX $282
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.