How much rates vary
Facilitymedian $1,380 · 10th to 90th $240 to $3,802Professionalmedian $813 · 10th to 90th $447 to $3,090
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 $457.09 Median $1,905.46 Typical High $14,454.40 | Facility | None | $457.09 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $3,235.94 | Professional | None | $426.58 | $457.09 | $3,235.94 |
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 $407.38 Median $1,348.96 Typical High $3,162.28 | Professional | None | $407.38 | $1,348.96 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $323.59 Typical High $1,258.93 | Facility | None | $50.12 | $323.59 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,737.80 | Professional | None | $457.09 | $562.34 | $1,737.80 |
DeanCare Setting Facility Modifier None Typical Low $457.09 Median $2,818.38 Typical High $5,128.61 | Facility | None | $457.09 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,348.96 | Professional | None | $724.44 | $851.14 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $954.99 Typical High $2,041.74 | Facility | None | $204.17 | $954.99 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,513.56 Typical High $3,090.30 | Professional | None | $478.63 | $1,513.56 | $3,090.30 |
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 $562.34 Median $912.01 Typical High $1,174.90 | Professional | None | $562.34 | $912.01 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $831.76 | Facility | None | $302.00 | $457.09 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $407.38 Median $831.76 Typical High $1,778.28 | Professional | None | $407.38 | $831.76 | $1,778.28 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $239.88 Typical High $389.05 | Facility | None | $50.12 | $239.88 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $676.08 | Professional | None | $512.86 | $562.34 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,737.80 | $2,238.72 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $1,862.09 | Professional | None | $407.38 | $676.08 | $1,862.09 |
10 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 Professional Modifier 52 · Reduced service Typical Low $213.80 Median $229.09 Typical High $1,621.81 | Professional | 52 · Reduced service | $213.80 | $229.09 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $91.20 Typical High $645.65 | Professional | 53 · Discontinued | $85.11 | $91.20 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $2,398.83 | Professional | 54 · Surgery only | $316.23 | $338.84 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $489.78 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $323.59 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $2,238.72 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $363.08 Median $426.58 Typical High $676.08 | Professional | 51 · Multiple procedures | $363.08 | $426.58 | $676.08 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $1,071.52 | Professional | 54 · Surgery only | $575.44 | $676.08 | $1,071.52 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $269.15 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $269.15 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $707.95 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $602.56 | $707.95 | $1,122.02 |
Where Wisconsin sits
The same service costs 4.2 times more in Wyoming than in Utah. 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
$891
WY $1,288UT $309
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.