How much rates vary
Facilitymedian $1,202 · 10th to 90th $178 to $3,802Professionalmedian $372 · 10th to 90th $151 to $813
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 $144.54 Median $239.88 Typical High $14,454.40 | Facility | None | $144.54 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $1,380.38 | Professional | None | $144.54 | $208.93 | $1,380.38 |
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 $162.18 Median $436.52 Typical High $776.25 | Professional | None | $162.18 | $436.52 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $630.96 Typical High $1,148.15 | Professional | 50 · Both sides | $223.87 | $630.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $323.59 Typical High $588.84 | Facility | None | $50.12 | $323.59 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $676.08 | Professional | None | $151.36 | $251.19 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $134.90 Median $2,570.40 Typical High $4,786.30 | Facility | None | $134.90 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $588.84 | Professional | None | $239.88 | $338.84 | $588.84 |
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 $204.17 Median $602.56 Typical High $1,023.29 | Professional | None | $204.17 | $602.56 | $1,023.29 |
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 $239.88 Median $416.87 Typical High $616.60 | Professional | None | $239.88 | $416.87 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $102.33 Median $204.17 Typical High $389.05 | Facility | None | $102.33 | $204.17 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $741.31 | Professional | None | $208.93 | $407.38 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $354.81 | Facility | None | $50.12 | $234.42 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $363.08 | Professional | None | $151.36 | $251.19 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $457.09 | Professional | None | $263.03 | $263.03 | $457.09 |
Security Health Setting Professional Modifier None Typical Low $288.40 Median $676.08 Typical High $1,122.02 | Professional | None | $288.40 | $676.08 | $1,122.02 |
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 $138.04 Median $371.54 Typical High $776.25 | Professional | None | $138.04 | $371.54 | $776.25 |
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 $72.44 Median $72.44 Typical High $120.23 | Facility | 52 · Reduced service | $72.44 | $72.44 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $47.86 | Facility | 53 · Discontinued | $28.84 | $28.84 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $107.15 Median $107.15 Typical High $177.83 | Facility | 54 · Surgery only | $107.15 | $107.15 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $35.48 | Facility | 55 · Aftercare only | $21.38 | $21.38 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $23.99 | Facility | 56 · Pre-op care only | $14.45 | $14.45 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $100.00 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $100.00 | $100.00 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $120.23 Typical High $691.83 | Professional | 52 · Reduced service | $72.44 | $120.23 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $47.86 Typical High $275.42 | Professional | 53 · Discontinued | $28.84 | $47.86 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $177.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $107.15 | $177.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $35.48 Typical High $208.93 | Professional | 55 · Aftercare only | $21.38 | $35.48 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.99 Typical High $138.04 | Professional | 56 · Pre-op care only | $14.45 | $23.99 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $165.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $100.00 | $165.96 | $977.24 |
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
$437
AK $457KY $102
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.