How much rates vary
Facilitymedian $1,259 · 10th to 90th $302 to $3,802Professionalmedian $851 · 10th to 90th $288 to $2,042
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 $229.09 Median $331.13 Typical High $14,454.40 | Facility | None | $229.09 | $331.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $2,951.21 | Professional | None | $229.09 | $331.13 | $2,951.21 |
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 $338.84 Median $1,071.52 Typical High $2,089.30 | Professional | None | $338.84 | $1,071.52 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $776.25 Typical High $1,096.48 | Facility | None | $489.78 | $776.25 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $1,258.93 | Professional | None | $281.84 | $457.09 | $1,258.93 |
DeanCare Setting Facility Modifier None Typical Low $263.03 Median $2,570.40 Typical High $4,786.30 | Facility | None | $263.03 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,122.02 | Professional | None | $446.68 | $645.65 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,202.26 Typical High $2,137.96 | Professional | None | $371.54 | $1,202.26 | $2,137.96 |
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 $501.19 Median $758.58 Typical High $1,174.90 | Professional | None | $501.19 | $758.58 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $676.08 | Facility | None | $223.87 | $331.13 | $676.08 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $707.95 Typical High $1,288.25 | Professional | None | $346.74 | $707.95 | $1,288.25 |
Quartz Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $1,071.52 | Facility | None | $467.74 | $630.96 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $794.33 | Professional | None | $281.84 | $407.38 | $794.33 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,148.15 | Professional | None | $758.58 | $758.58 | $1,148.15 |
Security Health Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,995.26 | Professional | None | $870.96 | $1,258.93 | $1,995.26 |
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 $281.84 Median $812.83 Typical High $1,621.81 | Professional | None | $281.84 | $812.83 | $1,621.81 |
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 $114.82 Median $114.82 Typical High $165.96 | Facility | 52 · Reduced service | $114.82 | $114.82 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $66.07 | Facility | 53 · Discontinued | $45.71 | $45.71 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $251.19 | Facility | 54 · Surgery only | $169.82 | $169.82 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $50.12 | Facility | 55 · Aftercare only | $33.88 | $33.88 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $33.11 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $158.49 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $165.96 Typical High $1,513.56 | Professional | 52 · Reduced service | $114.82 | $165.96 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $66.07 Typical High $602.56 | Professional | 53 · Discontinued | $45.71 | $66.07 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $251.19 Typical High $2,238.72 | Professional | 54 · Surgery only | $169.82 | $251.19 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $50.12 Typical High $457.09 | Professional | 55 · Aftercare only | $33.88 | $50.12 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.11 Typical High $302.00 | Professional | 56 · Pre-op care only | $22.91 | $33.11 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $234.42 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $158.49 | $234.42 | $2,089.30 |
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
$933
WI $933TX $251
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.