How much rates vary
Facilitymedian $1,202 · 10th to 90th $219 to $3,802Professionalmedian $490 · 10th to 90th $214 to $1,479
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 $208.93 Median $223.87 Typical High $14,454.40 | Facility | None | $208.93 | $223.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $1,348.96 | Professional | None | $194.98 | $223.87 | $1,348.96 |
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 $213.80 Median $741.31 Typical High $1,584.89 | Professional | None | $213.80 | $741.31 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $707.95 | Facility | None | $50.12 | $338.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $1,000.00 | Professional | None | $338.84 | $407.38 | $1,000.00 |
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 $354.81 Median $457.09 Typical High $630.96 | Professional | None | $354.81 | $457.09 | $630.96 |
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 $234.42 Median $870.96 Typical High $1,659.59 | Professional | None | $234.42 | $870.96 | $1,659.59 |
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 $281.84 Median $501.19 Typical High $660.69 | Professional | None | $281.84 | $501.19 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $436.52 | Facility | None | $199.53 | $251.19 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $912.01 | Professional | None | $354.81 | $588.84 | $912.01 |
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 $380.19 Median $407.38 Typical High $478.63 | Professional | None | $380.19 | $407.38 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | None | $676.08 | $676.08 | $724.44 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $1,148.15 Typical High $1,479.11 | Professional | None | $660.69 | $1,148.15 | $1,479.11 |
The Alliance Setting Professional Modifier None Typical Low $363.08 Median $776.25 Typical High $1,288.25 | Professional | None | $363.08 | $776.25 | $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 $218.78 Median $446.68 Typical High $1,023.29 | Professional | None | $218.78 | $446.68 | $1,023.29 |
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 $104.71 Median $104.71 Typical High $112.20 | Facility | 52 · Reduced service | $104.71 | $104.71 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $44.67 | Facility | 53 · Discontinued | $41.69 | $41.69 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $165.96 | Facility | 54 · Surgery only | $158.49 | $158.49 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $33.11 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $22.39 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $22.39 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $112.20 Typical High $794.33 | Professional | 52 · Reduced service | $104.71 | $112.20 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $316.23 | Professional | 53 · Discontinued | $41.69 | $44.67 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $1,174.90 | Professional | 54 · Surgery only | $158.49 | $165.96 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $234.42 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $158.49 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $154.88 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $147.91 | $154.88 | $1,096.48 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $177.83 Median $229.09 Typical High $316.23 | Professional | 51 · Multiple procedures | $177.83 | $229.09 | $316.23 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $371.54 Typical High $501.19 | Professional | 54 · Surgery only | $281.84 | $371.54 | $501.19 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $93.33 Typical High $125.89 | Professional | 55 · Aftercare only | $70.79 | $93.33 | $125.89 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $389.05 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $295.12 | $389.05 | $524.81 |
Where Wisconsin sits
The same service costs 5.1 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
$525
AK $871UT $170
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.