How much rates vary
Facilitymedian $1,202 · 10th to 90th $132 to $3,802Professionalmedian $251 · 10th to 90th $107 to $692
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 $93.33 Median $125.89 Typical High $14,454.40 | Facility | None | $93.33 | $125.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $912.01 | Professional | None | $93.33 | $125.89 | $912.01 |
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 $112.20 Median $331.13 Typical High $691.83 | Professional | None | $112.20 | $331.13 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $251.19 Typical High $398.11 | Facility | None | $50.12 | $251.19 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $524.81 | Professional | None | $169.82 | $229.09 | $524.81 |
DeanCare Setting Facility Modifier None Typical Low $104.71 Median $2,630.27 Typical High $5,128.61 | Facility | None | $104.71 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $316.23 | Professional | None | $165.96 | $223.87 | $316.23 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $1,778.28 | Facility | None | $141.25 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $467.74 Typical High $954.99 | Professional | None | $123.03 | $467.74 | $954.99 |
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 $158.49 Median $257.04 Typical High $354.81 | Professional | None | $158.49 | $257.04 | $354.81 |
Prevea360 Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $229.09 | Facility | None | $87.10 | $123.03 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $478.63 | Professional | None | $181.97 | $338.84 | $478.63 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $181.97 Typical High $275.42 | Facility | None | $50.12 | $181.97 | $275.42 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $275.42 | Professional | None | $169.82 | $218.78 | $275.42 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | None | $302.00 | $302.00 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $812.83 | Professional | None | $288.40 | $602.56 | $812.83 |
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 $102.33 Median $204.17 Typical High $549.54 | Professional | None | $102.33 | $204.17 | $549.54 |
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 $46.77 Median $46.77 Typical High $63.10 | Facility | 52 · Reduced service | $46.77 | $46.77 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $25.12 | Facility | 53 · Discontinued | $18.62 | $18.62 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $93.33 | Facility | 54 · Surgery only | $69.18 | $69.18 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $19.05 | Facility | 55 · Aftercare only | $13.80 | $13.80 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $12.59 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $12.59 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $64.57 Typical High $87.10 | Facility | 78 · Unplanned return to OR | $64.57 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $63.10 Typical High $489.78 | Professional | 52 · Reduced service | $46.77 | $63.10 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.12 Typical High $194.98 | Professional | 53 · Discontinued | $18.62 | $25.12 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $93.33 Typical High $741.31 | Professional | 54 · Surgery only | $69.18 | $93.33 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $147.91 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.59 Typical High $97.72 | Professional | 56 · Pre-op care only | $9.33 | $12.59 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $87.10 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $64.57 | $87.10 | $691.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $112.20 Typical High $158.49 | Professional | 51 · Multiple procedures | $83.18 | $112.20 | $158.49 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $131.83 | $177.83 | $257.04 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $44.67 Typical High $63.10 | Professional | 55 · Aftercare only | $33.11 | $44.67 | $63.10 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $138.04 | $190.55 | $269.15 |
Where Wisconsin sits
The same service costs 13.1 times more in Hawaii than in Maryland. 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.
Physician feeFacility fee
HI $2,944MD $224
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.