How much rates vary
Facilitymedian $3,020 · 10th to 90th $631 to $7,943Professionalmedian $1,122 · 10th to 90th $389 to $2,399
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 $316.23 Median $416.87 Typical High $14,454.40 | Facility | None | $316.23 | $416.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $1,995.26 | Professional | None | $316.23 | $416.87 | $1,995.26 |
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 $426.58 Median $1,318.26 Typical High $2,754.23 | Professional | None | $426.58 | $1,318.26 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,698.24 Typical High $3,715.35 | Facility | None | $891.25 | $1,698.24 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,584.89 | Professional | None | $398.11 | $602.56 | $1,584.89 |
DeanCare Setting Facility Modifier None Typical Low $346.74 Median $3,090.30 Typical High $5,370.32 | Facility | None | $346.74 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $1,258.93 | Professional | None | $616.60 | $891.25 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,818.38 Typical High $8,317.64 | Facility | None | $602.56 | $2,818.38 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $1,288.25 Typical High $2,398.83 | Professional | None | $436.52 | $1,288.25 | $2,398.83 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,479.11 | Professional | None | $549.54 | $954.99 | $1,479.11 |
Prevea360 Setting Facility Modifier None Typical Low $316.23 Median $416.87 Typical High $691.83 | Facility | None | $316.23 | $416.87 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $870.96 Typical High $1,621.81 | Professional | None | $426.58 | $870.96 | $1,621.81 |
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 $398.11 Median $512.86 Typical High $1,122.02 | Professional | None | $398.11 | $512.86 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,047.13 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,513.56 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,047.13 Typical High $1,905.46 | Professional | None | $363.08 | $1,047.13 | $1,905.46 |
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 $158.49 Median $158.49 Typical High $208.93 | Facility | 52 · Reduced service | $158.49 | $158.49 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $83.18 | Facility | 53 · Discontinued | $64.57 | $64.57 | $83.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $316.23 | Facility | 54 · Surgery only | $239.88 | $239.88 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $63.10 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $41.69 | Facility | 56 · Pre-op care only | $31.62 | $31.62 | $41.69 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $208.93 Typical High $1,000.00 | Professional | 52 · Reduced service | $158.49 | $208.93 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $407.38 | Professional | 53 · Discontinued | $64.57 | $83.18 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $1,513.56 | Professional | 54 · Surgery only | $239.88 | $316.23 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $302.00 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $204.17 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $1,412.54 |
Where Wisconsin sits
The same service costs 4.9 times more in Alaska 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· 2nd of 51
$1,288
AK $1,479UT $302
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.