How much rates vary
Facilitymedian $3,020 · 10th to 90th $490 to $7,762Professionalmedian $813 · 10th to 90th $355 to $2,138
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 $288.40 Median $426.58 Typical High $14,454.40 | Facility | None | $288.40 | $426.58 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $1,905.46 | Professional | None | $281.84 | $426.58 | $1,905.46 |
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 $389.05 Median $1,047.13 Typical High $2,137.96 | Professional | None | $389.05 | $1,047.13 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $1,548.82 Typical High $3,235.94 | Professional | 50 · Both sides | $588.84 | $1,548.82 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $1,584.89 | Facility | None | $457.09 | $851.14 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,778.28 | Professional | None | $524.81 | $776.25 | $1,778.28 |
DeanCare Setting Facility Modifier None Typical Low $338.84 Median $2,570.40 Typical High $4,786.30 | Facility | None | $338.84 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,071.52 | Professional | None | $512.86 | $724.44 | $1,071.52 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,096.48 Typical High $1,621.81 | Professional | 50 · Both sides | $758.58 | $1,096.48 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $2,511.89 Typical High $8,317.64 | Facility | None | $575.44 | $2,511.89 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,778.28 Typical High $3,235.94 | Professional | None | $467.74 | $1,778.28 | $3,235.94 |
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 $537.03 Median $851.14 Typical High $1,258.93 | Professional | None | $537.03 | $851.14 | $1,258.93 |
Prevea360 Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $691.83 | Facility | None | $281.84 | $457.09 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $1,819.70 | Professional | None | $501.19 | $977.24 | $1,819.70 |
Quartz Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $1,479.11 | Facility | None | $457.09 | $691.83 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $933.25 | Professional | None | $524.81 | $707.95 | $933.25 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $1,412.54 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $1,862.09 Typical High $2,818.38 | Professional | None | $933.25 | $1,862.09 | $2,818.38 |
The Alliance Setting Professional Modifier None Typical Low $549.54 Median $1,174.90 Typical High $2,511.89 | Professional | None | $549.54 | $1,174.90 | $2,511.89 |
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 $346.74 Median $676.08 Typical High $1,862.09 | Professional | None | $346.74 | $676.08 | $1,862.09 |
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 $144.54 Median $144.54 Typical High $213.80 | Facility | 52 · Reduced service | $144.54 | $144.54 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $85.11 | Facility | 53 · Discontinued | $57.54 | $57.54 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $316.23 | Facility | 54 · Surgery only | $213.80 | $213.80 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $64.57 | Facility | 55 · Aftercare only | $42.66 | $42.66 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $42.66 | Facility | 56 · Pre-op care only | $28.84 | $28.84 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $199.53 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $213.80 Typical High $1,174.90 | Professional | 52 · Reduced service | $144.54 | $213.80 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $85.11 Typical High $467.74 | Professional | 53 · Discontinued | $57.54 | $85.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $316.23 Typical High $1,737.80 | Professional | 54 · Surgery only | $213.80 | $316.23 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $64.57 Typical High $354.81 | Professional | 55 · Aftercare only | $42.66 | $64.57 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $42.66 Typical High $234.42 | Professional | 56 · Pre-op care only | $28.84 | $42.66 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $295.12 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $199.53 | $295.12 | $1,621.81 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $363.08 Typical High $537.03 | Professional | 51 · Multiple procedures | $257.04 | $363.08 | $537.03 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $575.44 Typical High $870.96 | Professional | 54 · Surgery only | $407.38 | $575.44 | $870.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $213.80 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $213.80 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $602.56 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $426.58 | $602.56 | $912.01 |
Where Wisconsin sits
The same service costs 4.7 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
$933
AK $1,175UT $251
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.