How much rates vary
Facilitymedian $3,467 · 10th to 90th $977 to $7,943Professionalmedian $1,514 · 10th to 90th $490 to $3,548
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 $457.09 Median $3,090.30 Typical High $14,454.40 | Facility | None | $457.09 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $4,677.35 | Professional | None | $457.09 | $457.09 | $4,677.35 |
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 $602.56 Median $1,819.70 Typical High $3,548.13 | Professional | None | $602.56 | $1,819.70 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $3,162.28 | Facility | None | $1,000.00 | $1,819.70 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,737.80 | Professional | None | $724.44 | $1,071.52 | $1,737.80 |
DeanCare Setting Facility Modifier None Typical Low $537.03 Median $3,162.28 Typical High $5,888.44 | Facility | None | $537.03 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,584.89 | Professional | None | $870.96 | $1,288.25 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $8,317.64 | Facility | None | $741.31 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,318.26 Typical High $2,691.53 | Professional | None | $549.54 | $1,318.26 | $2,691.53 |
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 $707.95 Median $1,230.27 Typical High $1,737.80 | Professional | None | $707.95 | $1,230.27 | $1,737.80 |
Prevea360 Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $977.24 | Facility | None | $446.68 | $562.34 | $977.24 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,258.93 Typical High $2,089.30 | Professional | None | $549.54 | $1,258.93 | $2,089.30 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $3,467.37 | Facility | None | $724.44 | $2,187.76 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,621.81 | Professional | None | $776.25 | $912.01 | $1,621.81 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,630.27 | $3,630.78 |
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 $489.78 Median $1,202.26 Typical High $2,570.40 | Professional | None | $489.78 | $1,202.26 | $2,570.40 |
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 $229.09 Median $229.09 Typical High $2,344.23 | Professional | 52 · Reduced service | $229.09 | $229.09 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $933.25 | Professional | 53 · Discontinued | $91.20 | $91.20 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $3,548.13 | Professional | 54 · Surgery only | $346.74 | $346.74 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $707.95 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $467.74 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $3,311.31 |
Where Wisconsin sits
The same service costs 5.5 times more in Alaska 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· 2nd of 51
$1,905
AK $2,042UT $372
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.