How much rates vary
Facilitymedian $2,754 · 10th to 90th $589 to $5,754Professionalmedian $603 · 10th to 90th $224 to $1,230
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 $239.88 Median $1,905.46 Typical High $14,454.40 | Facility | None | $239.88 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $1,621.81 | Professional | None | $239.88 | $239.88 | $1,621.81 |
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 $245.47 Median $741.31 Typical High $1,288.25 | Professional | None | $245.47 | $741.31 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $1,122.02 Typical High $1,949.84 | Professional | 50 · Both sides | $363.08 | $1,122.02 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $1,659.59 | Facility | None | $501.19 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $741.31 | Professional | None | $257.04 | $416.87 | $741.31 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $2,818.38 Typical High $5,128.61 | Facility | None | $208.93 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $602.56 | Professional | None | $338.84 | $501.19 | $602.56 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,398.83 Typical High $4,365.16 | Facility | None | $489.78 | $2,398.83 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $602.56 Typical High $1,318.26 | Professional | None | $218.78 | $602.56 | $1,318.26 |
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 $275.42 Median $489.78 Typical High $630.96 | Professional | None | $275.42 | $489.78 | $630.96 |
Prevea360 Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $389.05 | Facility | None | $173.78 | $218.78 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $426.58 Typical High $831.76 | Professional | None | $186.21 | $426.58 | $831.76 |
Quartz Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $1,905.46 | Facility | None | $676.08 | $1,230.27 | $1,905.46 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $616.60 | Professional | None | $257.04 | $257.04 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Security Health Setting Professional Modifier None Typical Low $467.74 Median $1,023.29 Typical High $1,148.15 | Professional | None | $467.74 | $1,023.29 | $1,148.15 |
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 $181.97 Median $575.44 Typical High $933.25 | Professional | None | $181.97 | $575.44 | $933.25 |
6 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 Professional Modifier 52 · Reduced service Typical Low $120.23 Median $120.23 Typical High $812.83 | Professional | 52 · Reduced service | $120.23 | $120.23 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $323.59 | Professional | 53 · Discontinued | $47.86 | $47.86 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $1,230.27 | Professional | 54 · Surgery only | $181.97 | $181.97 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $245.47 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $162.18 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $1,148.15 |
Where Wisconsin sits
The same service costs 8.9 times more in Oklahoma than in Utah. 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· 3rd of 51
$813
OK $1,413UT $158
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.