How much rates vary
Facilitymedian $14,454 · 10th to 90th $955 to $23,988Professionalmedian $1,148 · 10th to 90th $427 to $2,570
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 $426.58 Median $6,456.54 Typical High $14,454.40 | Facility | None | $426.58 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $3,801.89 | Professional | None | $426.58 | $426.58 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $23,988.33 | Facility | None | $12,022.64 | $16,982.44 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,288.25 Typical High $2,818.38 | Professional | None | $371.54 | $1,288.25 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,548.82 Typical High $19,054.61 | Facility | None | $831.76 | $1,548.82 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,778.28 | Professional | None | $562.34 | $1,023.29 | $1,778.28 |
DeanCare Setting Facility Modifier None Typical Low $371.54 Median $4,365.16 Typical High $7,762.47 | Facility | None | $371.54 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,096.48 | Professional | None | $691.83 | $851.14 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $9,120.11 Typical High $34,673.69 | Facility | None | $1,174.90 | $9,120.11 | $34,673.69 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $1,862.09 | Professional | None | $457.09 | $1,148.15 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $1,096.48 | Professional | None | $467.74 | $812.83 | $1,096.48 |
Prevea360 Setting Facility Modifier None Typical Low $295.12 Median $407.38 Typical High $691.83 | Facility | None | $295.12 | $407.38 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $776.25 Typical High $1,445.44 | Professional | None | $338.84 | $776.25 | $1,445.44 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $13,803.84 Typical High $20,892.96 | Facility | None | $812.83 | $13,803.84 | $20,892.96 |
Quartz Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $741.31 | Professional | None | $562.34 | $562.34 | $741.31 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,089.30 | $2,344.23 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,964.78 Typical High $27,542.29 | Facility | None | $2,041.74 | $10,964.78 | $27,542.29 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,148.15 Typical High $1,778.28 | Professional | None | $380.19 | $1,148.15 | $1,778.28 |
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 $213.80 Median $213.80 Typical High $1,905.46 | Professional | 52 · Reduced service | $213.80 | $213.80 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $758.58 | Professional | 53 · Discontinued | $85.11 | $85.11 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $2,818.38 | Professional | 54 · Surgery only | $323.59 | $323.59 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $562.34 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $380.19 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $2,630.27 |
Where Wisconsin sits
The same service costs 22.3 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 $22,356MT $1,003
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.