How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,175 to $10,965Professionalmedian $2,239 · 10th to 90th $603 to $8,318
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 $1,862.09 Typical High $14,454.40 | Facility | None | $426.58 | $1,862.09 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $1,862.09 Typical High $7,079.46 | Professional | None | $426.58 | $1,862.09 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $2,398.83 Typical High $9,549.93 | Professional | None | $758.58 | $2,398.83 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $3,548.13 Typical High $14,454.40 | Professional | 50 · Both sides | $1,148.15 | $3,548.13 | $14,454.40 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $4,897.79 | Facility | None | $954.99 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $2,344.23 Typical High $5,128.61 | Professional | None | $602.56 | $2,344.23 | $5,128.61 |
DeanCare Setting Facility Modifier None Typical Low $398.11 Median $4,265.80 Typical High $7,762.47 | Facility | None | $398.11 | $4,265.80 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $4,265.80 | Professional | None | $758.58 | $1,096.48 | $4,265.80 |
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 $1,479.11 Median $4,897.79 Typical High $8,511.38 | Professional | None | $1,479.11 | $4,897.79 | $8,511.38 |
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 $891.25 Median $2,041.74 Typical High $4,677.35 | Professional | None | $891.25 | $2,041.74 | $4,677.35 |
Prevea360 Setting Facility Modifier None Typical Low $346.74 Median $812.83 Typical High $2,691.53 | Facility | None | $346.74 | $812.83 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $707.95 Median $1,778.28 Typical High $6,165.95 | Professional | None | $707.95 | $1,778.28 | $6,165.95 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $4,466.84 | Facility | None | $758.58 | $2,691.53 | $4,466.84 |
Quartz Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,630.27 | Professional | None | $602.56 | $1,122.02 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $7,943.28 | Professional | None | $1,659.59 | $1,659.59 | $7,943.28 |
Security Health Setting Professional Modifier None Typical Low $1,778.28 Median $5,128.61 Typical High $10,964.78 | Professional | None | $1,778.28 | $5,128.61 | $10,964.78 |
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 $467.74 Median $1,737.80 Typical High $7,244.36 | Professional | None | $467.74 | $1,737.80 | $7,244.36 |
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 $213.80 Median $213.80 Typical High $912.01 | Facility | 52 · Reduced service | $213.80 | $213.80 | $912.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $371.54 | Facility | 53 · Discontinued | $85.11 | $85.11 | $371.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,380.38 | Facility | 54 · Surgery only | $316.23 | $316.23 | $1,380.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $275.42 | Facility | 55 · Aftercare only | $63.10 | $63.10 | $275.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $186.21 | Facility | 56 · Pre-op care only | $42.66 | $42.66 | $186.21 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $1,288.25 | Facility | 78 · Unplanned return to OR | $295.12 | $295.12 | $1,288.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $912.01 Typical High $3,548.13 | Professional | 52 · Reduced service | $213.80 | $912.01 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $371.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $85.11 | $371.54 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $1,380.38 Typical High $5,248.07 | Professional | 54 · Surgery only | $316.23 | $1,380.38 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $275.42 Typical High $1,047.13 | Professional | 55 · Aftercare only | $63.10 | $275.42 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $186.21 Typical High $707.95 | Professional | 56 · Pre-op care only | $42.66 | $186.21 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $1,288.25 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $295.12 | $1,288.25 | $4,897.79 |
Where Wisconsin sits
The same service costs 5.8 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
$2,818
AK $3,548NE $617
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.