How much rates vary
Facilitymedian $5,129 · 10th to 90th $776 to $9,120Professionalmedian $1,380 · 10th to 90th $646 to $3,715
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 $489.78 Median $645.65 Typical High $14,454.40 | Facility | None | $489.78 | $645.65 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $5,370.32 | Professional | None | $489.78 | $645.65 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,819.70 Typical High $3,890.45 | Professional | None | $645.65 | $1,819.70 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $4,168.69 | Facility | None | $1,202.26 | $2,398.83 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,754.23 | Professional | None | $812.83 | $1,174.90 | $2,754.23 |
DeanCare Setting Facility Modifier None Typical Low $562.34 Median $4,786.30 Typical High $8,912.51 | Facility | None | $562.34 | $4,786.30 | $8,912.51 |
DeanCare Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,659.59 | Professional | None | $870.96 | $1,174.90 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $8,709.64 | Facility | None | $724.44 | $2,818.38 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $2,691.53 Typical High $4,897.79 | Professional | None | $758.58 | $2,691.53 | $4,897.79 |
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 $831.76 Median $1,479.11 Typical High $1,995.26 | Professional | None | $831.76 | $1,479.11 | $1,995.26 |
Prevea360 Setting Facility Modifier None Typical Low $478.63 Median $724.44 Typical High $1,047.13 | Facility | None | $478.63 | $724.44 | $1,047.13 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,818.38 | Professional | None | $812.83 | $1,513.56 | $2,818.38 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $3,019.95 Typical High $4,570.88 | Facility | None | $933.25 | $3,019.95 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,412.54 | Professional | None | $891.25 | $1,148.15 | $1,412.54 |
Security Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,621.81 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $4,265.80 | Professional | None | $1,905.46 | $3,162.28 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $3,162.28 | Professional | None | $602.56 | $1,148.15 | $3,162.28 |
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 $245.47 Median $245.47 Typical High $323.59 | Facility | 52 · Reduced service | $245.47 | $245.47 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $131.83 | Facility | 53 · Discontinued | $97.72 | $97.72 | $131.83 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $489.78 | Facility | 54 · Surgery only | $363.08 | $363.08 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $97.72 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $97.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $64.57 | Facility | 56 · Pre-op care only | $48.98 | $48.98 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $338.84 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $323.59 Typical High $2,691.53 | Professional | 52 · Reduced service | $245.47 | $323.59 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $131.83 Typical High $1,071.52 | Professional | 53 · Discontinued | $97.72 | $131.83 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $489.78 Typical High $4,073.80 | Professional | 54 · Surgery only | $363.08 | $489.78 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $97.72 Typical High $812.83 | Professional | 55 · Aftercare only | $72.44 | $97.72 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $64.57 Typical High $537.03 | Professional | 56 · Pre-op care only | $48.98 | $64.57 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $457.09 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $338.84 | $457.09 | $3,801.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $588.84 Typical High $831.76 | Professional | 51 · Multiple procedures | $436.52 | $588.84 | $831.76 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $933.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $691.83 | $933.25 | $1,318.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $234.42 Typical High $331.13 | Professional | 55 · Aftercare only | $173.78 | $234.42 | $331.13 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $977.24 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $724.44 | $977.24 | $1,380.38 |
Where Wisconsin sits
The same service costs 5.8 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
$1,622
AK $2,455TX $427
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.