How much rates vary
Facilitymedian $5,623 · 10th to 90th $676 to $11,220Professionalmedian $490 · 10th to 90th $229 to $2,291
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 $229.09 Median $1,905.46 Typical High $14,454.40 | Facility | None | $229.09 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $3,630.78 | Professional | None | $229.09 | $229.09 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,748.98 | Facility | None | $5,011.87 | $7,585.78 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $758.58 Typical High $1,819.70 | Professional | None | $239.88 | $758.58 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,071.52 Typical High $4,073.80 | Facility | None | $537.03 | $1,071.52 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $870.96 | Professional | None | $346.74 | $389.05 | $870.96 |
DeanCare Setting Facility Modifier None Typical Low $245.47 Median $2,754.23 Typical High $5,128.61 | Facility | None | $245.47 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $1,258.93 | Professional | None | $363.08 | $426.58 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $5,623.41 Typical High $10,964.78 | Facility | None | $741.31 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $851.14 Typical High $2,290.87 | Professional | None | $302.00 | $851.14 | $2,290.87 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $288.40 Median $831.76 Typical High $891.25 | Professional | None | $288.40 | $831.76 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $575.44 | Facility | None | $229.09 | $363.08 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $457.09 Typical High $1,148.15 | Professional | None | $223.87 | $457.09 | $1,148.15 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $2,691.53 Typical High $4,466.84 | Facility | None | $630.96 | $2,691.53 | $4,466.84 |
Quartz Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $489.78 | Professional | None | $389.05 | $389.05 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Security Health Setting Professional Modifier None Typical Low $575.44 Median $1,122.02 Typical High $1,412.54 | Professional | None | $575.44 | $1,122.02 | $1,412.54 |
The Alliance Setting Professional Modifier None Typical Low $338.84 Median $954.99 Typical High $1,584.89 | Professional | None | $338.84 | $954.99 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $1,122.02 | Professional | None | $234.42 | $457.09 | $1,122.02 |
7 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 $114.82 Median $114.82 Typical High $1,819.70 | Professional | 52 · Reduced service | $114.82 | $114.82 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $724.44 | Professional | 53 · Discontinued | $45.71 | $45.71 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $2,691.53 | Professional | 54 · Surgery only | $173.78 | $173.78 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $537.03 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $363.08 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $2,511.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $213.80 Typical High $630.96 | Professional | 51 · Multiple procedures | $181.97 | $213.80 | $630.96 |
Where Wisconsin sits
The same service costs 4.6 times more in Alaska 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
$646
AK $891UT $195
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.