How much rates vary
Facilitymedian $1,349 · 10th to 90th $182 to $3,981Professionalmedian $407 · 10th to 90th $162 to $891
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 $269.15 Typical High $14,454.40 | Facility | None | $154.88 | $269.15 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $1,174.90 | Professional | None | $154.88 | $269.15 | $1,174.90 |
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 $478.63 Typical High $851.14 | Professional | None | $181.97 | $478.63 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $562.34 Typical High $851.14 | Facility | None | $50.12 | $562.34 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $758.58 | Professional | None | $165.96 | $281.84 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $141.25 Median $2,630.27 Typical High $5,128.61 | Facility | None | $141.25 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $575.44 | Professional | None | $263.03 | $363.08 | $575.44 |
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 $223.87 Median $630.96 Typical High $1,071.52 | Professional | None | $223.87 | $630.96 | $1,071.52 |
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 $288.40 Median $501.19 Typical High $691.83 | Professional | None | $288.40 | $501.19 | $691.83 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $354.81 | Facility | None | $112.20 | $199.53 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $724.44 | Professional | None | $234.42 | $426.58 | $724.44 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $416.87 | Professional | None | $165.96 | $281.84 | $416.87 |
Security Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $524.81 | Professional | None | $302.00 | $302.00 | $524.81 |
Security Health Setting Professional Modifier None Typical Low $288.40 Median $741.31 Typical High $1,288.25 | Professional | None | $288.40 | $741.31 | $1,288.25 |
The Alliance Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,000.00 | Professional | None | $549.54 | $549.54 | $1,000.00 |
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 $154.88 Median $407.38 Typical High $812.83 | Professional | None | $154.88 | $407.38 | $812.83 |
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 $77.62 Median $77.62 Typical High $131.83 | Facility | 52 · Reduced service | $77.62 | $77.62 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $53.70 | Facility | 53 · Discontinued | $30.90 | $30.90 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $199.53 | Facility | 54 · Surgery only | $117.49 | $117.49 | $199.53 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $39.81 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $39.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $26.92 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $186.21 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $131.83 Typical High $616.60 | Professional | 52 · Reduced service | $77.62 | $131.83 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $53.70 Typical High $245.47 | Professional | 53 · Discontinued | $30.90 | $53.70 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $199.53 Typical High $933.25 | Professional | 54 · Surgery only | $117.49 | $199.53 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $39.81 Typical High $186.21 | Professional | 55 · Aftercare only | $23.44 | $39.81 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.92 Typical High $123.03 | Professional | 56 · Pre-op care only | $15.49 | $26.92 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $186.21 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $109.65 | $186.21 | $870.96 |
Where Wisconsin sits
The same service costs 4.5 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
$490
AK $501KY $112
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.