How much rates vary
Facilitymedian $2,570 · 10th to 90th $263 to $5,754Professionalmedian $513 · 10th to 90th $174 to $1,259
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 $138.04 Median $239.88 Typical High $14,454.40 | Facility | None | $138.04 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $1,288.25 | Professional | None | $138.04 | $239.88 | $1,288.25 |
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 $208.93 Median $676.08 Typical High $1,479.11 | Professional | None | $208.93 | $676.08 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $575.44 Typical High $1,071.52 | Facility | None | $275.42 | $575.44 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $933.25 | Professional | None | $169.82 | $295.12 | $933.25 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $2,630.27 Typical High $5,128.61 | Facility | None | $138.04 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $676.08 | Professional | None | $269.15 | $416.87 | $676.08 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $2,041.74 Typical High $4,786.30 | Facility | None | $251.19 | $2,041.74 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $707.95 Typical High $1,288.25 | Professional | None | $234.42 | $707.95 | $1,288.25 |
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 $295.12 Median $467.74 Typical High $870.96 | Professional | None | $295.12 | $467.74 | $870.96 |
Prevea360 Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $398.11 | Facility | None | $134.90 | $208.93 | $398.11 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $954.99 | Professional | None | $239.88 | $467.74 | $954.99 |
Quartz Setting Facility Modifier None Typical Low $275.42 Median $416.87 Typical High $1,288.25 | Facility | None | $275.42 | $416.87 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $489.78 | Professional | None | $169.82 | $295.12 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $812.83 | Professional | None | $446.68 | $446.68 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,230.27 | Professional | None | $501.19 | $741.31 | $1,230.27 |
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 $158.49 Median $446.68 Typical High $977.24 | Professional | None | $158.49 | $446.68 | $977.24 |
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 $69.18 Median $69.18 Typical High $120.23 | Facility | 52 · Reduced service | $69.18 | $69.18 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $47.86 | Facility | 53 · Discontinued | $27.54 | $27.54 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $177.83 | Facility | 54 · Surgery only | $102.33 | $102.33 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $36.31 | Facility | 55 · Aftercare only | $20.42 | $20.42 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $23.99 | Facility | 56 · Pre-op care only | $13.80 | $13.80 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $95.50 | $95.50 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $120.23 Typical High $660.69 | Professional | 52 · Reduced service | $69.18 | $120.23 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $47.86 Typical High $263.03 | Professional | 53 · Discontinued | $27.54 | $47.86 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $177.83 Typical High $977.24 | Professional | 54 · Surgery only | $102.33 | $177.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $36.31 Typical High $199.53 | Professional | 55 · Aftercare only | $20.42 | $36.31 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $23.99 Typical High $131.83 | Professional | 56 · Pre-op care only | $13.80 | $23.99 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $165.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $95.50 | $165.96 | $933.25 |
Where Wisconsin sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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
$631
WI $631KY $166
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.