How much rates vary
Facilitymedian $2,884 · 10th to 90th $617 to $5,888Professionalmedian $1,349 · 10th to 90th $501 to $3,090
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 $416.87 Median $588.84 Typical High $14,454.40 | Facility | None | $416.87 | $588.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $3,388.44 | Professional | None | $416.87 | $588.84 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $1,584.89 Typical High $3,388.44 | Professional | None | $575.44 | $1,584.89 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,000.00 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $2,238.72 | Professional | None | $478.63 | $724.44 | $2,238.72 |
DeanCare Setting Facility Modifier None Typical Low $436.52 Median $3,090.30 Typical High $5,370.32 | Facility | None | $436.52 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,412.54 | Professional | None | $660.69 | $933.25 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $6,309.57 | Facility | None | $588.84 | $2,187.76 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,737.80 Typical High $3,981.07 | Professional | None | $562.34 | $1,737.80 | $3,981.07 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,584.89 | Professional | None | $724.44 | $1,148.15 | $1,584.89 |
Prevea360 Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $891.25 | Facility | None | $407.38 | $588.84 | $891.25 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $2,290.87 | Professional | None | $588.84 | $1,148.15 | $2,290.87 |
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 $489.78 Median $602.56 Typical High $1,174.90 | Professional | None | $489.78 | $602.56 | $1,174.90 |
Security Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,348.96 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,949.84 | $2,884.03 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $436.52 Median $1,122.02 Typical High $2,344.23 | Professional | None | $436.52 | $1,122.02 | $2,344.23 |
16 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 $208.93 Median $208.93 Typical High $295.12 | Facility | 52 · Reduced service | $208.93 | $208.93 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $117.49 | Facility | 53 · Discontinued | $83.18 | $83.18 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $436.52 | Facility | 54 · Surgery only | $309.03 | $309.03 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $87.10 | Facility | 55 · Aftercare only | $61.66 | $61.66 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $58.88 | Facility | 56 · Pre-op care only | $41.69 | $41.69 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $288.40 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $295.12 Typical High $1,698.24 | Professional | 52 · Reduced service | $208.93 | $295.12 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $117.49 Typical High $676.08 | Professional | 53 · Discontinued | $83.18 | $117.49 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $436.52 Typical High $2,570.40 | Professional | 54 · Surgery only | $309.03 | $436.52 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $87.10 Typical High $512.86 | Professional | 55 · Aftercare only | $61.66 | $87.10 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $58.88 Typical High $338.84 | Professional | 56 · Pre-op care only | $41.69 | $58.88 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $407.38 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $288.40 | $407.38 | $2,398.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $467.74 Typical High $707.95 | Professional | 51 · Multiple procedures | $331.13 | $467.74 | $707.95 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $741.31 Typical High $1,122.02 | Professional | 54 · Surgery only | $524.81 | $741.31 | $1,122.02 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $186.21 Typical High $281.84 | Professional | 55 · Aftercare only | $131.83 | $186.21 | $281.84 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $776.25 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $549.54 | $776.25 | $1,174.90 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska than in Texas. 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
$1,585
AK $1,950TX $447
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.