How much rates vary
Facilitymedian $2,399 · 10th to 90th $339 to $5,754Professionalmedian $676 · 10th to 90th $229 to $1,549
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 $186.21 Median $281.84 Typical High $14,454.40 | Facility | None | $186.21 | $281.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $1,621.81 | Professional | None | $186.21 | $281.84 | $1,621.81 |
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 $269.15 Median $851.14 Typical High $1,778.28 | Professional | None | $269.15 | $851.14 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $1,071.52 | Facility | None | $338.84 | $630.96 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $1,096.48 | Professional | None | $229.09 | $371.54 | $1,096.48 |
DeanCare Setting Facility Modifier None Typical Low $186.21 Median $2,630.27 Typical High $5,128.61 | Facility | None | $186.21 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $870.96 | Professional | None | $363.08 | $549.54 | $870.96 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $2,041.74 Typical High $4,786.30 | Facility | None | $302.00 | $2,041.74 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $891.25 Typical High $1,659.59 | Professional | None | $269.15 | $891.25 | $1,659.59 |
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 $380.19 Median $630.96 Typical High $1,023.29 | Professional | None | $380.19 | $630.96 | $1,023.29 |
Prevea360 Setting Facility Modifier None Typical Low $154.88 Median $281.84 Typical High $501.19 | Facility | None | $154.88 | $281.84 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $549.54 Typical High $1,122.02 | Professional | None | $281.84 | $549.54 | $1,122.02 |
Quartz Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $1,071.52 | Facility | None | $338.84 | $446.68 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $660.69 | Professional | None | $229.09 | $346.74 | $660.69 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,000.00 | Professional | None | $630.96 | $630.96 | $1,000.00 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,513.56 | Professional | None | $676.08 | $954.99 | $1,513.56 |
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 $213.80 Median $616.60 Typical High $1,230.27 | Professional | None | $213.80 | $616.60 | $1,230.27 |
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 $93.33 Median $93.33 Typical High $141.25 | Facility | 52 · Reduced service | $93.33 | $93.33 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $56.23 | Facility | 53 · Discontinued | $37.15 | $37.15 | $56.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $213.80 | Facility | 54 · Surgery only | $138.04 | $138.04 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $42.66 | Facility | 55 · Aftercare only | $27.54 | $27.54 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $28.18 | Facility | 56 · Pre-op care only | $18.62 | $18.62 | $28.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $128.82 | $128.82 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $141.25 Typical High $831.76 | Professional | 52 · Reduced service | $93.33 | $141.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $56.23 Typical High $331.13 | Professional | 53 · Discontinued | $37.15 | $56.23 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $1,230.27 | Professional | 54 · Surgery only | $138.04 | $213.80 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $251.19 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $1,148.15 |
Where Wisconsin sits
The same service costs 4.3 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
$794
WI $794KY $186
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.