How much rates vary
Facilitymedian $2,344 · 10th to 90th $195 to $5,623Professionalmedian $339 · 10th to 90th $141 to $724
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 $134.90 Median $194.98 Typical High $14,454.40 | Facility | None | $134.90 | $194.98 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $1,000.00 | Professional | None | $134.90 | $194.98 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $407.38 Typical High $724.44 | Professional | None | $144.54 | $407.38 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $407.38 Typical High $758.58 | Facility | None | $190.55 | $407.38 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $549.54 | Professional | None | $141.25 | $229.09 | $549.54 |
DeanCare Setting Facility Modifier None Typical Low $114.82 Median $2,630.27 Typical High $5,128.61 | Facility | None | $114.82 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $478.63 | Professional | None | $223.87 | $316.23 | $478.63 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $2,041.74 Typical High $4,365.16 | Facility | None | $186.21 | $2,041.74 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $489.78 Typical High $831.76 | Professional | None | $169.82 | $489.78 | $831.76 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $501.19 | Professional | None | $223.87 | $346.74 | $501.19 |
Prevea360 Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $288.40 | Facility | None | $95.50 | $151.36 | $288.40 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $602.56 | Professional | None | $173.78 | $338.84 | $602.56 |
Quartz Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $1,071.52 | Facility | None | $186.21 | $288.40 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $338.84 | Professional | None | $141.25 | $208.93 | $338.84 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $371.54 | Professional | None | $251.19 | $251.19 | $371.54 |
Security Health Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $912.01 | Professional | None | $331.13 | $630.96 | $912.01 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $125.89 Median $346.74 Typical High $630.96 | Professional | None | $125.89 | $346.74 | $630.96 |
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 $67.61 Median $67.61 Typical High $97.72 | Facility | 52 · Reduced service | $67.61 | $67.61 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $38.90 | Facility | 53 · Discontinued | $26.92 | $26.92 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $144.54 | Facility | 54 · Surgery only | $100.00 | $100.00 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $28.84 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $19.50 | Facility | 56 · Pre-op care only | $13.49 | $13.49 | $19.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $93.33 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $97.72 Typical High $501.19 | Professional | 52 · Reduced service | $67.61 | $97.72 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.90 Typical High $199.53 | Professional | 53 · Discontinued | $26.92 | $38.90 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $144.54 Typical High $741.31 | Professional | 54 · Surgery only | $100.00 | $144.54 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $147.91 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $13.49 | $19.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $134.90 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $93.33 | $134.90 | $691.83 |
Where Wisconsin sits
The same service costs 4.4 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
$417
AK $417KY $95.50
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.