How much rates vary
Facilitymedian $2,344 · 10th to 90th $219 to $4,786Professionalmedian $501 · 10th to 90th $166 to $1,148
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 $131.83 Median $218.78 Typical High $14,454.40 | Facility | None | $131.83 | $218.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $1,230.27 | Professional | None | $131.83 | $218.78 | $1,230.27 |
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 $213.80 Median $616.60 Typical High $1,380.38 | Professional | None | $213.80 | $616.60 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $537.03 Typical High $812.83 | Facility | None | $50.12 | $537.03 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $812.83 | Professional | None | $162.18 | $288.40 | $812.83 |
DeanCare Setting Facility Modifier None Typical Low $131.83 Median $2,630.27 Typical High $5,128.61 | Facility | None | $131.83 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $602.56 | Professional | None | $257.04 | $371.54 | $602.56 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $2,041.74 Typical High $4,365.16 | Facility | None | $229.09 | $2,041.74 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $645.65 Typical High $1,148.15 | Professional | None | $223.87 | $645.65 | $1,148.15 |
Network Health Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $4,786.30 | Facility | None | $954.99 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $741.31 | Professional | None | $288.40 | $501.19 | $741.31 |
Prevea360 Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $371.54 | Facility | None | $109.65 | $190.55 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $831.76 | Professional | None | $234.42 | $457.09 | $831.76 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $446.68 | Professional | None | $162.18 | $269.15 | $446.68 |
Security Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $707.95 | Professional | None | $407.38 | $407.38 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,096.48 | Professional | None | $501.19 | $660.69 | $1,096.48 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,677.35 | Facility | None | $707.95 | $2,754.23 | $4,677.35 |
United Setting Professional Modifier None Typical Low $162.18 Median $426.58 Typical High $912.01 | Professional | None | $162.18 | $426.58 | $912.01 |
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 $66.07 Median $66.07 Typical High $109.65 | Facility | 52 · Reduced service | $66.07 | $66.07 | $109.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $43.65 | Facility | 53 · Discontinued | $26.30 | $26.30 | $43.65 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $165.96 | Facility | 54 · Surgery only | $100.00 | $100.00 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $33.11 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $21.88 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $21.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $93.33 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $109.65 Typical High $602.56 | Professional | 52 · Reduced service | $66.07 | $109.65 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $43.65 Typical High $245.47 | Professional | 53 · Discontinued | $26.30 | $43.65 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $165.96 Typical High $912.01 | Professional | 54 · Surgery only | $100.00 | $165.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $33.11 Typical High $181.97 | Professional | 55 · Aftercare only | $19.95 | $33.11 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $123.03 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $154.88 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $93.33 | $154.88 | $851.14 |
Where Wisconsin sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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
$589
WI $589HI $155
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.