How much rates vary
Facilitymedian $2,818 · 10th to 90th $162 to $5,888Professionalmedian $347 · 10th to 90th $132 to $661
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 $112.20 Median $162.18 Typical High $14,454.40 | Facility | None | $112.20 | $162.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $562.34 | Professional | None | $112.20 | $154.88 | $562.34 |
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 $154.88 Median $407.38 Typical High $741.31 | Professional | None | $154.88 | $407.38 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $380.19 Typical High $1,023.29 | Facility | None | $158.49 | $380.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $512.86 | Professional | None | $134.90 | $218.78 | $512.86 |
DeanCare Setting Facility Modifier None Typical Low $107.15 Median $2,630.27 Typical High $5,128.61 | Facility | None | $107.15 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $389.05 | Professional | None | $208.93 | $302.00 | $389.05 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $2,187.76 Typical High $4,677.35 | Facility | None | $165.96 | $2,187.76 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $426.58 Typical High $724.44 | Professional | None | $141.25 | $426.58 | $724.44 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $457.09 | Professional | None | $204.17 | $288.40 | $457.09 |
Prevea360 Setting Facility Modifier None Typical Low $89.13 Median $151.36 Typical High $239.88 | Facility | None | $89.13 | $151.36 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $457.09 | Professional | None | $154.88 | $295.12 | $457.09 |
Quartz Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $1,288.25 | Facility | None | $154.88 | $234.42 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $323.59 | Professional | None | $134.90 | $190.55 | $323.59 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $380.19 | Professional | None | $257.04 | $257.04 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $676.08 | Professional | None | $288.40 | $467.74 | $676.08 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $117.49 Median $309.03 Typical High $562.34 | Professional | None | $117.49 | $309.03 | $562.34 |
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 $56.23 Median $56.23 Typical High $81.28 | Facility | 52 · Reduced service | $56.23 | $56.23 | $81.28 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $32.36 | Facility | 53 · Discontinued | $22.39 | $22.39 | $32.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $120.23 | Facility | 54 · Surgery only | $85.11 | $85.11 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $23.99 | Facility | 55 · Aftercare only | $16.98 | $16.98 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $16.22 | Facility | 56 · Pre-op care only | $11.22 | $11.22 | $16.22 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $112.20 | Facility | 78 · Unplanned return to OR | $79.43 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $81.28 Typical High $309.03 | Professional | 52 · Reduced service | $56.23 | $81.28 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $32.36 Typical High $123.03 | Professional | 53 · Discontinued | $22.39 | $32.36 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $120.23 Typical High $457.09 | Professional | 54 · Surgery only | $85.11 | $120.23 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $23.99 Typical High $91.20 | Professional | 55 · Aftercare only | $16.98 | $23.99 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.22 Typical High $61.66 | Professional | 56 · Pre-op care only | $11.22 | $16.22 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $112.20 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $79.43 | $112.20 | $426.58 |
Where Wisconsin sits
The same service costs 3.5 times more in Wisconsin 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· 1st of 51
$398
WI $398KY $115
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.