How much rates vary
Facilitymedian $1,259 · 10th to 90th $302 to $3,890Professionalmedian $813 · 10th to 90th $282 to $1,778
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 $229.09 Median $331.13 Typical High $14,454.40 | Facility | None | $229.09 | $331.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $1,862.09 | Professional | None | $229.09 | $331.13 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $977.24 Typical High $2,041.74 | Professional | None | $323.59 | $977.24 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $1,230.27 | Facility | None | $489.78 | $794.33 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $1,258.93 | Professional | None | $281.84 | $446.68 | $1,258.93 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $3,090.30 Typical High $5,370.32 | Facility | None | $251.19 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,023.29 | Professional | None | $436.52 | $645.65 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,047.13 Typical High $1,949.84 | Professional | None | $316.23 | $1,047.13 | $1,949.84 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $1,148.15 | Professional | None | $436.52 | $758.58 | $1,148.15 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $575.44 | Facility | None | $218.78 | $331.13 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $691.83 Typical High $1,258.93 | Professional | None | $338.84 | $691.83 | $1,258.93 |
Quartz Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $1,122.02 | Facility | None | $489.78 | $645.65 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $794.33 | Professional | None | $281.84 | $407.38 | $794.33 |
Security Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,071.52 | Professional | None | $724.44 | $724.44 | $1,071.52 |
Security Health Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,659.59 | Professional | None | $851.14 | $1,122.02 | $1,659.59 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $263.03 Median $758.58 Typical High $1,412.54 | Professional | None | $263.03 | $758.58 | $1,412.54 |
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 $112.20 Median $112.20 Typical High $165.96 | Facility | 52 · Reduced service | $112.20 | $112.20 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $66.07 | Facility | 53 · Discontinued | $45.71 | $45.71 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $245.47 | Facility | 54 · Surgery only | $169.82 | $169.82 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $48.98 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $33.11 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $158.49 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $165.96 Typical High $912.01 | Professional | 52 · Reduced service | $112.20 | $165.96 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $66.07 Typical High $371.54 | Professional | 53 · Discontinued | $45.71 | $66.07 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $245.47 Typical High $1,380.38 | Professional | 54 · Surgery only | $169.82 | $245.47 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $48.98 Typical High $275.42 | Professional | 55 · Aftercare only | $33.88 | $48.98 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.11 Typical High $186.21 | Professional | 56 · Pre-op care only | $22.91 | $33.11 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $229.09 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $158.49 | $229.09 | $1,288.25 |
Where Wisconsin sits
The same service costs 3.7 times more in Wisconsin 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· 1st of 51
$891
WI $891UT $240
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.