How much rates vary
Facilitymedian $3,467 · 10th to 90th $692 to $7,943Professionalmedian $1,349 · 10th to 90th $490 to $2,754
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 $467.74 Median $630.96 Typical High $14,454.40 | Facility | None | $467.74 | $630.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $3,467.37 | Professional | None | $467.74 | $630.96 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,621.81 Typical High $3,019.95 | Professional | None | $562.34 | $1,621.81 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $3,715.35 | Facility | None | $1,000.00 | $2,041.74 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,778.28 | Professional | None | $501.19 | $776.25 | $1,778.28 |
DeanCare Setting Facility Modifier None Typical Low $457.09 Median $3,090.30 Typical High $5,370.32 | Facility | None | $457.09 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,412.54 | Professional | None | $794.33 | $1,096.48 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,951.21 Typical High $8,317.64 | Facility | None | $616.60 | $2,951.21 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,445.44 Typical High $2,754.23 | Professional | None | $524.81 | $1,445.44 | $2,754.23 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,621.81 | Professional | None | $724.44 | $1,096.48 | $1,621.81 |
Prevea360 Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $758.58 | Facility | None | $407.38 | $537.03 | $758.58 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $1,778.28 | Professional | None | $537.03 | $1,122.02 | $1,778.28 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $4,073.80 | Facility | None | $724.44 | $2,454.71 | $4,073.80 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $1,230.27 | Professional | None | $501.19 | $676.08 | $1,230.27 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Security Health Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,071.52 | $2,089.30 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $436.52 Median $1,174.90 Typical High $1,949.84 | Professional | None | $436.52 | $1,174.90 | $1,949.84 |
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 $234.42 Median $234.42 Typical High $316.23 | Facility | 52 · Reduced service | $234.42 | $234.42 | $316.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $125.89 | Facility | 53 · Discontinued | $95.50 | $95.50 | $125.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $478.63 | Facility | 54 · Surgery only | $354.81 | $354.81 | $478.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | 55 · Aftercare only | $70.79 | $70.79 | $95.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $63.10 | Facility | 56 · Pre-op care only | $46.77 | $46.77 | $63.10 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $446.68 | Facility | 78 · Unplanned return to OR | $331.13 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $316.23 Typical High $1,737.80 | Professional | 52 · Reduced service | $234.42 | $316.23 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $125.89 Typical High $691.83 | Professional | 53 · Discontinued | $95.50 | $125.89 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $478.63 Typical High $2,630.27 | Professional | 54 · Surgery only | $354.81 | $478.63 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $95.50 Typical High $524.81 | Professional | 55 · Aftercare only | $70.79 | $95.50 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $63.10 Typical High $346.74 | Professional | 56 · Pre-op care only | $46.77 | $63.10 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $446.68 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $331.13 | $446.68 | $2,454.71 |
Where Wisconsin sits
The same service costs 4.2 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $5,214MT $1,234
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.