How much rates vary
Facilitymedian $1,259 · 10th to 90th $282 to $3,802Professionalmedian $832 · 10th to 90th $275 to $1,862
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 $223.87 Median $323.59 Typical High $14,454.40 | Facility | None | $223.87 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $3,019.95 | Professional | None | $223.87 | $323.59 | $3,019.95 |
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 $1,000.00 Typical High $2,137.96 | Professional | None | $323.59 | $1,000.00 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $707.95 Typical High $1,202.26 | Facility | None | $323.59 | $707.95 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $1,148.15 | Professional | None | $275.42 | $457.09 | $1,148.15 |
DeanCare Setting Facility Modifier None Typical Low $257.04 Median $3,090.30 Typical High $5,370.32 | Facility | None | $257.04 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,047.13 | Professional | None | $436.52 | $630.96 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,023.29 Typical High $1,995.26 | Professional | None | $338.84 | $1,023.29 | $1,995.26 |
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 $426.58 Median $776.25 Typical High $1,122.02 | Professional | None | $426.58 | $776.25 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $575.44 | Facility | None | $218.78 | $323.59 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $323.59 Median $660.69 Typical High $1,230.27 | Professional | None | $323.59 | $660.69 | $1,230.27 |
Quartz Setting Facility Modifier None Typical Low $316.23 Median $478.63 Typical High $1,122.02 | Facility | None | $316.23 | $478.63 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $794.33 | Professional | None | $275.42 | $398.11 | $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 $870.96 Median $1,148.15 Typical High $1,621.81 | Professional | None | $870.96 | $1,148.15 | $1,621.81 |
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 $269.15 Median $776.25 Typical High $1,445.44 | Professional | None | $269.15 | $776.25 | $1,445.44 |
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 $162.18 | Facility | 52 · Reduced service | $112.20 | $112.20 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $64.57 | Facility | 53 · Discontinued | $44.67 | $44.67 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $239.88 | Facility | 54 · Surgery only | $169.82 | $169.82 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $47.86 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $32.36 | Facility | 56 · Pre-op care only | $22.39 | $22.39 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $223.87 | Facility | 78 · Unplanned return to OR | $158.49 | $158.49 | $223.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $162.18 Typical High $1,513.56 | Professional | 52 · Reduced service | $112.20 | $162.18 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $64.57 Typical High $602.56 | Professional | 53 · Discontinued | $44.67 | $64.57 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $239.88 Typical High $2,290.87 | Professional | 54 · Surgery only | $169.82 | $239.88 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $47.86 Typical High $457.09 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $302.00 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $223.87 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $158.49 | $223.87 | $2,137.96 |
Where Wisconsin sits
The same service costs 3.7 times more in Wisconsin 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· 1st of 51
$891
WI $891TX $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.