How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $12,882Professionalmedian $2,455 · 10th to 90th $603 to $8,913
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 $398.11 Median $1,412.54 Typical High $14,454.40 | Facility | None | $398.11 | $1,412.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,412.54 Typical High $19,054.61 | Professional | None | $398.11 | $1,412.54 | $19,054.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,511.38 Typical High $12,882.50 | Facility | None | $5,128.61 | $8,511.38 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $2,691.53 Typical High $8,912.51 | Professional | None | $776.25 | $2,691.53 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $4,265.80 | Facility | None | $1,023.29 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,584.89 Typical High $5,011.87 | Professional | None | $524.81 | $1,584.89 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $446.68 Median $5,011.87 Typical High $9,332.54 | Facility | None | $446.68 | $5,011.87 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $831.76 Median $2,041.74 Typical High $6,309.57 | Professional | None | $831.76 | $2,041.74 | $6,309.57 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $5,248.07 Typical High $12,882.50 | Facility | None | $954.99 | $5,248.07 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $5,248.07 Typical High $12,882.50 | Professional | None | $1,905.46 | $5,248.07 | $12,882.50 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $5,370.32 | Professional | None | $1,258.93 | $2,137.96 | $5,370.32 |
Prevea360 Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $2,884.03 | Facility | None | $389.05 | $1,230.27 | $2,884.03 |
Quartz Setting Professional Modifier None Typical Low $776.25 Median $2,187.76 Typical High $6,025.60 | Professional | None | $776.25 | $2,187.76 | $6,025.60 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $3,388.44 | Facility | None | $812.83 | $2,137.96 | $3,388.44 |
Quartz Setting Professional Modifier None Typical Low $524.81 Median $1,258.93 Typical High $2,951.21 | Professional | None | $524.81 | $1,258.93 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $7,413.10 | Professional | None | $1,949.84 | $1,949.84 | $7,413.10 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $11,481.54 | Professional | None | $2,290.87 | $3,548.13 | $11,481.54 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $588.84 Median $2,041.74 Typical High $6,918.31 | Professional | None | $588.84 | $2,041.74 | $6,918.31 |
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 $199.53 Median $199.53 Typical High $691.83 | Facility | 52 · Reduced service | $199.53 | $199.53 | $691.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $281.84 | Facility | 53 · Discontinued | $79.43 | $79.43 | $281.84 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $1,047.13 | Facility | 54 · Surgery only | $302.00 | $302.00 | $1,047.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $208.93 | Facility | 55 · Aftercare only | $60.26 | $60.26 | $208.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $141.25 | Facility | 56 · Pre-op care only | $39.81 | $39.81 | $141.25 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $977.24 | Facility | 78 · Unplanned return to OR | $281.84 | $281.84 | $977.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $691.83 Typical High $9,549.93 | Professional | 52 · Reduced service | $199.53 | $691.83 | $9,549.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $281.84 Typical High $3,801.89 | Professional | 53 · Discontinued | $79.43 | $281.84 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $1,047.13 Typical High $14,454.40 | Professional | 54 · Surgery only | $302.00 | $1,047.13 | $14,454.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $208.93 Typical High $2,884.03 | Professional | 55 · Aftercare only | $60.26 | $208.93 | $2,884.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $141.25 Typical High $1,905.46 | Professional | 56 · Pre-op care only | $39.81 | $141.25 | $1,905.46 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $977.24 Typical High $13,489.63 | Professional | 78 · Unplanned return to OR | $281.84 | $977.24 | $13,489.63 |
Where Wisconsin sits
The same service costs 4.9 times more in Alaska than in Texas. 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
$2,951
AK $3,020TX $617
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.