How much rates vary
Facilitymedian $2,344 · 10th to 90th $178 to $5,623Professionalmedian $257 · 10th to 90th $135 to $912
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 $123.03 Median $162.18 Typical High $14,454.40 | Facility | None | $123.03 | $162.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $912.01 | Professional | None | $123.03 | $162.18 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $426.58 Typical High $1,000.00 | Professional | None | $144.54 | $426.58 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $389.05 Typical High $758.58 | Facility | None | $165.96 | $389.05 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $467.74 | Professional | None | $151.36 | $199.53 | $467.74 |
DeanCare Setting Facility Modifier None Typical Low $134.90 Median $2,570.40 Typical High $4,786.30 | Facility | None | $134.90 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $407.38 | Professional | None | $194.98 | $263.03 | $407.38 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $2,187.76 Typical High $4,365.16 | Facility | None | $190.55 | $2,187.76 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $831.76 Typical High $1,096.48 | Professional | None | $186.21 | $831.76 | $1,096.48 |
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 $251.19 Median $346.74 Typical High $426.58 | Professional | None | $251.19 | $346.74 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $123.03 Median $165.96 Typical High $302.00 | Facility | None | $123.03 | $165.96 | $302.00 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $549.54 | Professional | None | $165.96 | $323.59 | $549.54 |
Quartz Setting Facility Modifier None Typical Low $165.96 Median $251.19 Typical High $1,071.52 | Facility | None | $165.96 | $251.19 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $245.47 | Professional | None | $151.36 | $199.53 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $741.31 | Professional | None | $389.05 | $562.34 | $741.31 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $630.96 | Professional | None | $125.89 | $213.80 | $630.96 |
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 $61.66 Median $61.66 Typical High $81.28 | Facility | 52 · Reduced service | $61.66 | $61.66 | $81.28 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $32.36 | Facility | 53 · Discontinued | $24.55 | $24.55 | $32.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $120.23 | Facility | 54 · Surgery only | $93.33 | $93.33 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $24.55 | Facility | 55 · Aftercare only | $18.62 | $18.62 | $24.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $16.22 | Facility | 56 · Pre-op care only | $12.30 | $12.30 | $16.22 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $112.20 | Facility | 78 · Unplanned return to OR | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $81.28 Typical High $501.19 | Professional | 52 · Reduced service | $61.66 | $81.28 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $32.36 Typical High $199.53 | Professional | 53 · Discontinued | $24.55 | $32.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $758.58 | Professional | 54 · Surgery only | $93.33 | $120.23 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $151.36 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.22 Typical High $100.00 | Professional | 56 · Pre-op care only | $12.30 | $16.22 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $112.20 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $87.10 | $112.20 | $707.95 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $97.72 Median $131.83 Typical High $199.53 | Professional | 51 · Multiple procedures | $97.72 | $131.83 | $199.53 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $323.59 | Professional | 54 · Surgery only | $154.88 | $208.93 | $323.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $81.28 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $81.28 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $218.78 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $165.96 | $218.78 | $338.84 |
Where Wisconsin sits
The same service costs 4.0 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
$288
AK $437NJ $110
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.