How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,148 to $11,220Professionalmedian $2,239 · 10th to 90th $692 to $7,943
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 $489.78 Median $1,548.82 Typical High $14,454.40 | Facility | None | $489.78 | $1,548.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $1,548.82 Typical High $10,232.93 | Professional | None | $489.78 | $1,548.82 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $2,570.40 Typical High $7,943.28 | Professional | None | $870.96 | $2,570.40 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $3,890.45 Typical High $11,748.98 | Professional | 50 · Both sides | $1,230.27 | $3,890.45 | $11,748.98 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $4,677.35 | Facility | None | $954.99 | $3,162.28 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $2,137.96 Typical High $4,365.16 | Professional | None | $691.83 | $2,137.96 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $457.09 Median $4,265.80 Typical High $7,762.47 | Facility | None | $457.09 | $4,265.80 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $3,630.78 | Professional | None | $870.96 | $1,258.93 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $4,265.80 Typical High $10,964.78 | Facility | None | $912.01 | $4,265.80 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $4,570.88 Typical High $7,413.10 | Professional | None | $1,445.44 | $4,570.88 | $7,413.10 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $4,168.69 | Professional | None | $977.24 | $1,698.24 | $4,168.69 |
Prevea360 Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $2,454.71 | Facility | None | $398.11 | $776.25 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $1,621.81 Typical High $5,248.07 | Professional | None | $812.83 | $1,621.81 | $5,248.07 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $4,466.84 | Facility | None | $758.58 | $2,884.03 | $4,466.84 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $2,187.76 | Professional | None | $691.83 | $1,288.25 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $6,760.83 | Professional | None | $1,905.46 | $1,905.46 | $6,760.83 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $9,332.54 | Professional | None | $1,905.46 | $2,884.03 | $9,332.54 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,819.70 Typical High $6,456.54 | Professional | None | $537.03 | $1,819.70 | $6,456.54 |
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 $245.47 Median $245.47 Typical High $776.25 | Facility | 52 · Reduced service | $245.47 | $245.47 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $316.23 | Facility | 53 · Discontinued | $97.72 | $97.72 | $316.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $1,174.90 | Facility | 54 · Surgery only | $363.08 | $363.08 | $1,174.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $234.42 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $154.88 | Facility | 56 · Pre-op care only | $48.98 | $48.98 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $1,096.48 | Facility | 78 · Unplanned return to OR | $338.84 | $338.84 | $1,096.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $776.25 Typical High $5,128.61 | Professional | 52 · Reduced service | $245.47 | $776.25 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $316.23 Typical High $2,041.74 | Professional | 53 · Discontinued | $97.72 | $316.23 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $1,174.90 Typical High $7,762.47 | Professional | 54 · Surgery only | $363.08 | $1,174.90 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $234.42 Typical High $1,548.82 | Professional | 55 · Aftercare only | $72.44 | $234.42 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $154.88 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $48.98 | $154.88 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $1,096.48 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $338.84 | $1,096.48 | $7,244.36 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$2,754
AK $3,020NE $692
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.