How much rates vary
Facilitymedian $2,818 · 10th to 90th $575 to $5,888Professionalmedian $646 · 10th to 90th $331 to $2,239
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 $295.12 Median $407.38 Typical High $14,454.40 | Facility | None | $295.12 | $407.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $2,238.72 | Professional | None | $295.12 | $407.38 | $2,238.72 |
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 $354.81 Median $1,047.13 Typical High $2,511.89 | Professional | None | $354.81 | $1,047.13 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $3,715.35 | Facility | None | $891.25 | $1,659.59 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $1,122.02 | Professional | None | $363.08 | $501.19 | $1,122.02 |
DeanCare Setting Facility Modifier None Typical Low $331.13 Median $3,090.30 Typical High $5,370.32 | Facility | None | $331.13 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,000.00 | Professional | None | $467.74 | $645.65 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,187.76 Typical High $6,309.57 | Facility | None | $489.78 | $2,187.76 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $1,995.26 Typical High $2,691.53 | Professional | None | $436.52 | $1,995.26 | $2,691.53 |
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 $616.60 Median $831.76 Typical High $1,047.13 | Professional | None | $616.60 | $831.76 | $1,047.13 |
Prevea360 Setting Facility Modifier None Typical Low $295.12 Median $407.38 Typical High $691.83 | Facility | None | $295.12 | $407.38 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $776.25 Typical High $1,348.96 | Professional | None | $398.11 | $776.25 | $1,348.96 |
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 $363.08 Median $478.63 Typical High $602.56 | Professional | None | $363.08 | $478.63 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,348.96 | Professional | None | $977.24 | $977.24 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,348.96 | $1,862.09 |
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 $316.23 Median $537.03 Typical High $1,548.82 | Professional | None | $316.23 | $537.03 | $1,548.82 |
16 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 $147.91 Median $147.91 Typical High $199.53 | Facility | 52 · Reduced service | $147.91 | $147.91 | $199.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $81.28 | Facility | 53 · Discontinued | $58.88 | $58.88 | $81.28 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $302.00 | Facility | 54 · Surgery only | $223.87 | $223.87 | $302.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $60.26 | Facility | 55 · Aftercare only | $44.67 | $44.67 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $40.74 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $40.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $281.84 | Facility | 78 · Unplanned return to OR | $208.93 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $199.53 Typical High $1,122.02 | Professional | 52 · Reduced service | $147.91 | $199.53 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $81.28 Typical High $446.68 | Professional | 53 · Discontinued | $58.88 | $81.28 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $302.00 Typical High $1,659.59 | Professional | 54 · Surgery only | $223.87 | $302.00 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $60.26 Typical High $331.13 | Professional | 55 · Aftercare only | $44.67 | $60.26 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $40.74 Typical High $223.87 | Professional | 56 · Pre-op care only | $29.51 | $40.74 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $281.84 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $208.93 | $281.84 | $1,548.82 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $323.59 Typical High $501.19 | Professional | 51 · Multiple procedures | $234.42 | $323.59 | $501.19 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $512.86 Typical High $794.33 | Professional | 54 · Surgery only | $371.54 | $512.86 | $794.33 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $199.53 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $199.53 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $537.03 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $389.05 | $537.03 | $851.14 |
Where Wisconsin sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 3rd of 51
$724
AK $1,072NJ $263
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.