How much rates vary
Facilitymedian $1,230 · 10th to 90th $269 to $3,802Professionalmedian $457 · 10th to 90th $174 to $1,318
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 $154.88 Median $269.15 Typical High $14,454.40 | Facility | None | $154.88 | $269.15 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $1,174.90 | Professional | None | $154.88 | $263.03 | $1,174.90 |
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 $199.53 Median $562.34 Typical High $1,548.82 | Professional | None | $199.53 | $562.34 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $602.56 Typical High $1,071.52 | Facility | None | $331.13 | $602.56 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $660.69 | Professional | None | $239.88 | $426.58 | $660.69 |
DeanCare Setting Facility Modifier None Typical Low $151.36 Median $2,630.27 Typical High $5,128.61 | Facility | None | $151.36 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $645.65 | Professional | None | $245.47 | $426.58 | $645.65 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $912.01 Typical High $1,778.28 | Facility | None | $162.18 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,778.28 | Professional | None | $288.40 | $1,023.29 | $1,778.28 |
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 $309.03 Median $501.19 Typical High $616.60 | Professional | None | $309.03 | $501.19 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $229.09 Typical High $457.09 | Facility | None | $131.83 | $229.09 | $457.09 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $478.63 Typical High $977.24 | Professional | None | $223.87 | $478.63 | $977.24 |
Quartz Setting Facility Modifier None Typical Low $323.59 Median $436.52 Typical High $1,071.52 | Facility | None | $323.59 | $436.52 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $501.19 | Professional | None | $263.03 | $316.23 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $891.25 | Professional | None | $501.19 | $501.19 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,230.27 | Professional | None | $489.78 | $776.25 | $1,230.27 |
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 $162.18 Median $323.59 Typical High $977.24 | Professional | None | $162.18 | $323.59 | $977.24 |
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 $77.62 Median $77.62 Typical High $134.90 | Facility | 52 · Reduced service | $77.62 | $77.62 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $53.70 | Facility | 53 · Discontinued | $30.90 | $30.90 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $204.17 | Facility | 54 · Surgery only | $114.82 | $114.82 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $40.74 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $26.92 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $134.90 Typical High $660.69 | Professional | 52 · Reduced service | $77.62 | $134.90 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $53.70 Typical High $263.03 | Professional | 53 · Discontinued | $30.90 | $53.70 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $204.17 Typical High $977.24 | Professional | 54 · Surgery only | $114.82 | $204.17 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $40.74 Typical High $194.98 | Professional | 55 · Aftercare only | $22.91 | $40.74 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.92 Typical High $131.83 | Professional | 56 · Pre-op care only | $15.49 | $26.92 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $190.55 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $107.15 | $190.55 | $912.01 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $120.23 Median $213.80 Typical High $323.59 | Professional | 51 · Multiple procedures | $120.23 | $213.80 | $323.59 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $338.84 Typical High $524.81 | Professional | 54 · Surgery only | $194.98 | $338.84 | $524.81 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $85.11 Typical High $131.83 | Professional | 55 · Aftercare only | $48.98 | $85.11 | $131.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $363.08 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $204.17 | $363.08 | $549.54 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 2nd of 51
$457
AK $562DC $162
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.