How much rates vary
Facilitymedian $1,259 · 10th to 90th $204 to $3,802Professionalmedian $437 · 10th to 90th $170 to $1,023
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 $158.49 Median $338.84 Typical High $14,454.40 | Facility | None | $158.49 | $338.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $338.84 Typical High $1,621.81 | Professional | None | $158.49 | $338.84 | $1,621.81 |
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 $181.97 Median $467.74 Typical High $851.14 | Professional | None | $181.97 | $467.74 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $537.03 Typical High $831.76 | Facility | None | $50.12 | $537.03 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $977.24 | Professional | None | $169.82 | $363.08 | $977.24 |
DeanCare Setting Facility Modifier None Typical Low $144.54 Median $2,630.27 Typical High $5,128.61 | Facility | None | $144.54 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $741.31 | Professional | None | $263.03 | $380.19 | $741.31 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $1,778.28 | Facility | None | $154.88 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $794.33 Typical High $1,288.25 | Professional | None | $269.15 | $794.33 | $1,288.25 |
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 $269.15 Median $524.81 Typical High $891.25 | Professional | None | $269.15 | $524.81 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $234.42 Typical High $457.09 | Facility | None | $112.20 | $234.42 | $457.09 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $489.78 Typical High $933.25 | Professional | None | $245.47 | $489.78 | $933.25 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $389.05 Typical High $588.84 | Facility | None | $50.12 | $389.05 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $363.08 Typical High $478.63 | Professional | None | $169.82 | $363.08 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $676.08 | Professional | None | $295.12 | $295.12 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $1,659.59 | Professional | None | $323.59 | $741.31 | $1,659.59 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $158.49 Median $426.58 Typical High $1,096.48 | Professional | None | $158.49 | $426.58 | $1,096.48 |
12 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 $79.43 Median $79.43 Typical High $169.82 | Facility | 52 · Reduced service | $79.43 | $79.43 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $67.61 | Facility | 53 · Discontinued | $31.62 | $31.62 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $257.04 | Facility | 54 · Surgery only | $117.49 | $117.49 | $257.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $51.29 | Facility | 55 · Aftercare only | $23.99 | $23.99 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $33.88 | Facility | 56 · Pre-op care only | $15.85 | $15.85 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $239.88 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $169.82 Typical High $831.76 | Professional | 52 · Reduced service | $79.43 | $169.82 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $67.61 Typical High $331.13 | Professional | 53 · Discontinued | $31.62 | $67.61 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $257.04 Typical High $1,230.27 | Professional | 54 · Surgery only | $117.49 | $257.04 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $51.29 Typical High $245.47 | Professional | 55 · Aftercare only | $23.99 | $51.29 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $33.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $15.85 | $33.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $239.88 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $109.65 | $239.88 | $1,148.15 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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 $562KY $145
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.