How much rates vary
Facilitymedian $3,467 · 10th to 90th $437 to $7,943Professionalmedian $646 · 10th to 90th $224 to $1,445
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 $194.98 Median $223.87 Typical High $14,454.40 | Facility | None | $194.98 | $223.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $1,995.26 | Professional | None | $194.98 | $223.87 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $741.31 Typical High $1,479.11 | Professional | None | $269.15 | $741.31 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,122.02 Typical High $4,365.16 | Facility | None | $562.34 | $1,122.02 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $758.58 | Professional | None | $251.19 | $363.08 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $213.80 Median $3,090.30 Typical High $5,370.32 | Facility | None | $213.80 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $676.08 | Professional | None | $371.54 | $524.81 | $676.08 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $2,818.38 Typical High $8,709.64 | Facility | None | $371.54 | $2,818.38 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $676.08 Typical High $1,380.38 | Professional | None | $245.47 | $676.08 | $1,380.38 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $707.95 | Professional | None | $316.23 | $537.03 | $707.95 |
Prevea360 Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $436.52 | Facility | None | $186.21 | $234.42 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $851.14 | Professional | None | $269.15 | $512.86 | $851.14 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $4,786.30 | Facility | None | $724.44 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $616.60 | Professional | None | $251.19 | $295.12 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | None | $954.99 | $954.99 | $1,096.48 |
Security Health Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,548.82 | Professional | None | $912.01 | $1,258.93 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $213.80 Median $602.56 Typical High $1,071.52 | Professional | None | $213.80 | $602.56 | $1,071.52 |
12 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 $97.72 Median $97.72 Typical High $112.20 | Facility | 52 · Reduced service | $97.72 | $97.72 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $44.67 | Facility | 53 · Discontinued | $38.90 | $38.90 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $165.96 | Facility | 54 · Surgery only | $144.54 | $144.54 | $165.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $33.11 | Facility | 55 · Aftercare only | $28.84 | $28.84 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $22.39 | Facility | 56 · Pre-op care only | $19.50 | $19.50 | $22.39 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $154.88 | Facility | 78 · Unplanned return to OR | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $112.20 Typical High $1,000.00 | Professional | 52 · Reduced service | $97.72 | $112.20 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $398.11 | Professional | 53 · Discontinued | $38.90 | $44.67 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $144.54 | $165.96 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $295.12 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $199.53 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $1,380.38 |
Where Wisconsin sits
The same service costs 5.9 times more in Oklahoma 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
$759
OK $1,175UT $200
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.