How much rates vary
Facilitymedian $1,202 · 10th to 90th $214 to $3,802Professionalmedian $468 · 10th to 90th $209 to $1,380
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 $194.98 Median $213.80 Typical High $14,454.40 | Facility | None | $194.98 | $213.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $1,584.89 | Professional | None | $186.21 | $213.80 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $691.83 Typical High $1,479.11 | Professional | None | $208.93 | $691.83 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $691.83 | Facility | None | $50.12 | $338.84 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $933.25 | Professional | None | $323.59 | $389.05 | $933.25 |
DeanCare Setting Facility Modifier None Typical Low $218.78 Median $2,630.27 Typical High $5,128.61 | Facility | None | $218.78 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $602.56 | Professional | None | $338.84 | $426.58 | $602.56 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $851.14 Typical High $1,621.81 | Professional | None | $229.09 | $851.14 | $1,621.81 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $660.69 | Professional | None | $275.42 | $512.86 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $416.87 | Facility | None | $190.55 | $239.88 | $416.87 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $870.96 | Professional | None | $331.13 | $575.44 | $870.96 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $371.54 | Facility | None | $50.12 | $245.47 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $467.74 | Professional | None | $354.81 | $389.05 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | None | $630.96 | $630.96 | $691.83 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $1,122.02 Typical High $1,412.54 | Professional | None | $630.96 | $1,122.02 | $1,412.54 |
The Alliance Setting Professional Modifier None Typical Low $338.84 Median $912.01 Typical High $1,288.25 | Professional | None | $338.84 | $912.01 | $1,288.25 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $1,000.00 | Professional | None | $208.93 | $436.52 | $1,000.00 |
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 $97.72 Median $97.72 Typical High $107.15 | Facility | 52 · Reduced service | $97.72 | $97.72 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $43.65 | Facility | 53 · Discontinued | $38.90 | $38.90 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $162.18 | Facility | 54 · Surgery only | $147.91 | $147.91 | $162.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $32.36 | Facility | 55 · Aftercare only | $29.51 | $29.51 | $32.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $21.38 | Facility | 56 · Pre-op care only | $19.50 | $19.50 | $21.38 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $138.04 Typical High $151.36 | Facility | 78 · Unplanned return to OR | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $107.15 Typical High $870.96 | Professional | 52 · Reduced service | $97.72 | $107.15 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $346.74 | Professional | 53 · Discontinued | $38.90 | $43.65 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $162.18 Typical High $1,318.26 | Professional | 54 · Surgery only | $147.91 | $162.18 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $32.36 Typical High $263.03 | Professional | 55 · Aftercare only | $29.51 | $32.36 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.38 Typical High $173.78 | Professional | 56 · Pre-op care only | $19.50 | $21.38 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $151.36 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $138.04 | $151.36 | $1,230.27 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $213.80 Typical High $302.00 | Professional | 51 · Multiple procedures | $169.82 | $213.80 | $302.00 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $489.78 | Professional | 54 · Surgery only | $275.42 | $346.74 | $489.78 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $123.03 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $123.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $512.86 |
Where Wisconsin sits
The same service costs 4.8 times more in Alaska than in Florida. 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
$513
AK $794FL $166
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.