How much rates vary
Facilitymedian $1,202 · 10th to 90th $186 to $3,890Professionalmedian $389 · 10th to 90th $174 to $1,148
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 $154.88 Median $186.21 Typical High $14,454.40 | Facility | None | $154.88 | $186.21 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $1,258.93 | Professional | None | $154.88 | $186.21 | $1,258.93 |
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 $173.78 Median $537.03 Typical High $1,148.15 | Professional | None | $173.78 | $537.03 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $812.83 Typical High $1,737.80 | Professional | 50 · Both sides | $263.03 | $812.83 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $588.84 | Facility | None | $50.12 | $338.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $758.58 | Professional | None | $251.19 | $338.84 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $173.78 Median $3,162.28 Typical High $5,888.44 | Facility | None | $173.78 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | None | $275.42 | $338.84 | $489.78 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $512.86 Typical High $724.44 | Professional | 50 · Both sides | $416.87 | $512.86 | $724.44 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $912.01 Typical High $1,778.28 | Facility | None | $177.83 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $707.95 Typical High $1,380.38 | Professional | None | $190.55 | $707.95 | $1,380.38 |
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 $234.42 Median $426.58 Typical High $549.54 | Professional | None | $234.42 | $426.58 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $346.74 | Facility | None | $147.91 | $208.93 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $724.44 | Professional | None | $263.03 | $467.74 | $724.44 |
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 $281.84 Median $338.84 Typical High $407.38 | Professional | None | $281.84 | $338.84 | $407.38 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | None | $489.78 | $489.78 | $588.84 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,202.26 | Professional | None | $489.78 | $912.01 | $1,202.26 |
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 $169.82 Median $338.84 Typical High $831.76 | Professional | None | $169.82 | $338.84 | $831.76 |
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 $77.62 Median $77.62 Typical High $93.33 | Facility | 52 · Reduced service | $77.62 | $77.62 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $37.15 | Facility | 53 · Discontinued | $30.90 | $30.90 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $138.04 | Facility | 54 · Surgery only | $114.82 | $114.82 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $27.54 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $18.62 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $18.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $128.82 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $93.33 Typical High $630.96 | Professional | 52 · Reduced service | $77.62 | $93.33 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $37.15 Typical High $251.19 | Professional | 53 · Discontinued | $30.90 | $37.15 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $954.99 | Professional | 54 · Surgery only | $114.82 | $138.04 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $190.55 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.62 Typical High $125.89 | Professional | 56 · Pre-op care only | $15.49 | $18.62 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $891.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $169.82 Typical High $245.47 | Professional | 51 · Multiple procedures | $138.04 | $169.82 | $245.47 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $269.15 Typical High $389.05 | Professional | 54 · Surgery only | $218.78 | $269.15 | $389.05 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $67.61 Typical High $97.72 | Professional | 55 · Aftercare only | $54.95 | $67.61 | $97.72 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $281.84 | $407.38 |
Where Wisconsin sits
The same service costs 4.6 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
$427
AK $617FL $135
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.