How much rates vary
Facilitymedian $1,202 · 10th to 90th $170 to $3,802Professionalmedian $355 · 10th to 90th $158 to $1,047
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 $147.91 Median $169.82 Typical High $14,454.40 | Facility | None | $147.91 | $169.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $1,023.29 | Professional | None | $141.25 | $169.82 | $1,023.29 |
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 $158.49 Median $524.81 Typical High $1,096.48 | Professional | None | $158.49 | $524.81 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $537.03 | Facility | None | $50.12 | $295.12 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $707.95 | Professional | None | $245.47 | $302.00 | $707.95 |
DeanCare Setting Facility Modifier None Typical Low $165.96 Median $3,162.28 Typical High $5,888.44 | Facility | None | $165.96 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $467.74 | Professional | None | $263.03 | $323.59 | $467.74 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $912.01 Typical High $1,778.28 | Facility | None | $165.96 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $645.65 Typical High $1,258.93 | Professional | None | $169.82 | $645.65 | $1,258.93 |
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 $213.80 Median $380.19 Typical High $489.78 | Professional | None | $213.80 | $380.19 | $489.78 |
Prevea360 Setting Facility Modifier None Typical Low $144.54 Median $190.55 Typical High $316.23 | Facility | None | $144.54 | $190.55 | $316.23 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $660.69 | Professional | None | $245.47 | $436.52 | $660.69 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $213.80 Typical High $323.59 | Facility | None | $50.12 | $213.80 | $323.59 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $363.08 | Professional | None | $269.15 | $302.00 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $1,096.48 | Professional | None | $467.74 | $831.76 | $1,096.48 |
The Alliance Setting Professional Modifier None Typical Low $245.47 Median $831.76 Typical High $1,096.48 | Professional | None | $245.47 | $831.76 | $1,096.48 |
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 $158.49 Median $331.13 Typical High $776.25 | Professional | None | $158.49 | $331.13 | $776.25 |
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 $74.13 Median $74.13 Typical High $85.11 | Facility | 52 · Reduced service | $74.13 | $74.13 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $33.88 | Facility | 53 · Discontinued | $29.51 | $29.51 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $125.89 | Facility | 54 · Surgery only | $109.65 | $109.65 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $25.12 | Facility | 55 · Aftercare only | $21.88 | $21.88 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $16.98 | Facility | 56 · Pre-op care only | $14.79 | $14.79 | $16.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $102.33 Typical High $117.49 | Facility | 78 · Unplanned return to OR | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $85.11 Typical High $562.34 | Professional | 52 · Reduced service | $74.13 | $85.11 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.88 Typical High $223.87 | Professional | 53 · Discontinued | $29.51 | $33.88 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $831.76 | Professional | 54 · Surgery only | $109.65 | $125.89 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $169.82 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $112.20 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $776.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $131.83 Median $162.18 Typical High $234.42 | Professional | 51 · Multiple procedures | $131.83 | $162.18 | $234.42 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $371.54 | Professional | 54 · Surgery only | $208.93 | $257.04 | $371.54 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $93.33 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $93.33 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $269.15 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $218.78 | $269.15 | $389.05 |
Where Wisconsin sits
The same service costs 4.9 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
$380
AK $603UT $123
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.