How much rates vary
Facilitymedian $1,950 · 10th to 90th $380 to $4,365Professionalmedian $550 · 10th to 90th $209 to $1,479
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 $204.17 Median $346.74 Typical High $14,454.40 | Facility | None | $204.17 | $346.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $1,047.13 | Professional | None | $199.53 | $323.59 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $724.44 Typical High $1,698.24 | Professional | None | $275.42 | $724.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $851.14 Typical High $1,288.25 | Facility | None | $489.78 | $851.14 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $831.76 | Professional | None | $309.03 | $537.03 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $2,630.27 Typical High $5,128.61 | Facility | None | $204.17 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $645.65 | Professional | None | $323.59 | $549.54 | $645.65 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,412.54 Typical High $3,019.95 | Facility | None | $346.74 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,380.38 Typical High $2,290.87 | Professional | None | $295.12 | $1,380.38 | $2,290.87 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $724.44 | Professional | None | $288.40 | $512.86 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $147.91 Median $309.03 Typical High $549.54 | Facility | None | $147.91 | $309.03 | $549.54 |
Quartz Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,122.02 | Professional | None | $331.13 | $588.84 | $1,122.02 |
Quartz Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $1,288.25 | Facility | None | $478.63 | $645.65 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $616.60 | Professional | None | $338.84 | $416.87 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,202.26 | Professional | None | $691.83 | $691.83 | $1,202.26 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $933.25 Typical High $1,584.89 | Professional | None | $489.78 | $933.25 | $1,584.89 |
The Alliance Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,584.89 | $1,949.84 | $2,454.71 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,548.13 | Facility | None | $512.86 | $2,238.72 | $3,548.13 |
United Setting Professional Modifier None Typical Low $177.83 Median $380.19 Typical High $1,202.26 | Professional | None | $177.83 | $380.19 | $1,202.26 |
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 $102.33 Median $102.33 Typical High $173.78 | Facility | 52 · Reduced service | $102.33 | $102.33 | $173.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $69.18 | Facility | 53 · Discontinued | $40.74 | $40.74 | $69.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $263.03 | Facility | 54 · Surgery only | $154.88 | $154.88 | $263.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $52.48 | Facility | 55 · Aftercare only | $30.90 | $30.90 | $52.48 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $34.67 | Facility | 56 · Pre-op care only | $20.42 | $20.42 | $34.67 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $245.47 | Facility | 78 · Unplanned return to OR | $144.54 | $144.54 | $245.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $173.78 Typical High $575.44 | Professional | 52 · Reduced service | $102.33 | $173.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $69.18 Typical High $229.09 | Professional | 53 · Discontinued | $40.74 | $69.18 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $263.03 Typical High $870.96 | Professional | 54 · Surgery only | $154.88 | $263.03 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $52.48 Typical High $173.78 | Professional | 55 · Aftercare only | $30.90 | $52.48 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $34.67 Typical High $114.82 | Professional | 56 · Pre-op care only | $20.42 | $34.67 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $245.47 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $144.54 | $245.47 | $812.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $275.42 Typical High $323.59 | Professional | 51 · Multiple procedures | $162.18 | $275.42 | $323.59 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $263.03 | $436.52 | $524.81 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $64.57 | $109.65 | $128.82 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $275.42 | $457.09 | $549.54 |
Where Wisconsin sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$589
AK $741KY $166
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.