How much rates vary
Facilitymedian $2,570 · 10th to 90th $417 to $5,623Professionalmedian $372 · 10th to 90th $195 to $1,259
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 $173.78 Median $239.88 Typical High $14,454.40 | Facility | None | $173.78 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $1,174.90 | Professional | None | $173.78 | $239.88 | $1,174.90 |
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 $208.93 Median $602.56 Typical High $1,380.38 | Professional | None | $208.93 | $602.56 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $1,659.59 | Facility | None | $575.44 | $977.24 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $660.69 | Professional | None | $213.80 | $295.12 | $660.69 |
DeanCare Setting Facility Modifier None Typical Low $173.78 Median $2,570.40 Typical High $4,786.30 | Facility | None | $173.78 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $588.84 | Professional | None | $275.42 | $380.19 | $588.84 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $2,187.76 Typical High $4,786.30 | Facility | None | $363.08 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,174.90 Typical High $1,621.81 | Professional | None | $263.03 | $1,174.90 | $1,621.81 |
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 $354.81 Median $489.78 Typical High $588.84 | Professional | None | $354.81 | $489.78 | $588.84 |
Prevea360 Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $436.52 | Facility | None | $144.54 | $234.42 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $776.25 | Professional | None | $229.09 | $446.68 | $776.25 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,905.46 | Facility | None | $630.96 | $1,202.26 | $1,905.46 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $363.08 | Professional | None | $213.80 | $275.42 | $363.08 |
Security Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $794.33 | Professional | None | $562.34 | $562.34 | $794.33 |
Security Health Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,096.48 | Professional | None | $562.34 | $794.33 | $1,096.48 |
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 $177.83 Median $302.00 Typical High $912.01 | Professional | None | $177.83 | $302.00 | $912.01 |
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 $87.10 Median $87.10 Typical High $117.49 | Facility | 52 · Reduced service | $87.10 | $87.10 | $117.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $47.86 | Facility | 53 · Discontinued | $34.67 | $34.67 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $177.83 | Facility | 54 · Surgery only | $131.83 | $131.83 | $177.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $35.48 | Facility | 55 · Aftercare only | $26.30 | $26.30 | $35.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $23.99 | Facility | 56 · Pre-op care only | $17.38 | $17.38 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $165.96 | Facility | 78 · Unplanned return to OR | $123.03 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $117.49 Typical High $602.56 | Professional | 52 · Reduced service | $87.10 | $117.49 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $47.86 Typical High $239.88 | Professional | 53 · Discontinued | $34.67 | $47.86 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $177.83 Typical High $891.25 | Professional | 54 · Surgery only | $131.83 | $177.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $35.48 Typical High $181.97 | Professional | 55 · Aftercare only | $26.30 | $35.48 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.99 Typical High $120.23 | Professional | 56 · Pre-op care only | $17.38 | $23.99 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $165.96 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $123.03 | $165.96 | $851.14 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $138.04 Median $190.55 Typical High $295.12 | Professional | 51 · Multiple procedures | $138.04 | $190.55 | $295.12 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $302.00 Typical High $467.74 | Professional | 54 · Surgery only | $218.78 | $302.00 | $467.74 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $75.86 Typical High $117.49 | Professional | 55 · Aftercare only | $54.95 | $75.86 | $117.49 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $501.19 |
Where Wisconsin sits
The same service costs 4.2 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
$427
AK $646NJ $155
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.