How much rates vary
Facilitymedian $2,884 · 10th to 90th $427 to $5,888Professionalmedian $589 · 10th to 90th $224 to $1,148
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 $199.53 Median $257.04 Typical High $14,454.40 | Facility | None | $199.53 | $257.04 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $1,174.90 | Professional | None | $199.53 | $251.19 | $1,174.90 |
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 $257.04 Median $724.44 Typical High $1,230.27 | Professional | None | $257.04 | $724.44 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,096.48 Typical High $2,818.38 | Facility | None | $602.56 | $1,096.48 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $831.76 | Professional | None | $239.88 | $371.54 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $2,570.40 Typical High $4,786.30 | Facility | None | $204.17 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $724.44 | Professional | None | $380.19 | $549.54 | $724.44 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $2,187.76 Typical High $5,623.41 | Facility | None | $371.54 | $2,187.76 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $562.34 Typical High $1,148.15 | Professional | None | $251.19 | $562.34 | $1,148.15 |
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 $331.13 Median $537.03 Typical High $741.31 | Professional | None | $331.13 | $537.03 | $741.31 |
Prevea360 Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $467.74 | Facility | None | $162.18 | $251.19 | $467.74 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $741.31 | Professional | None | $245.47 | $512.86 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $3,090.30 | Facility | None | $537.03 | $1,905.46 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $575.44 | Professional | None | $239.88 | $309.03 | $575.44 |
Security Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | None | $467.74 | $467.74 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,096.48 | Professional | None | $537.03 | $851.14 | $1,096.48 |
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 $213.80 Median $549.54 Typical High $1,000.00 | Professional | None | $213.80 | $549.54 | $1,000.00 |
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 $100.00 Median $100.00 Typical High $128.82 | Facility | 52 · Reduced service | $100.00 | $100.00 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | 53 · Discontinued | $40.74 | $40.74 | $52.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $194.98 | Facility | 54 · Surgery only | $151.36 | $151.36 | $194.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $38.90 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $25.70 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $128.82 Typical High $645.65 | Professional | 52 · Reduced service | $100.00 | $128.82 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $52.48 Typical High $257.04 | Professional | 53 · Discontinued | $40.74 | $52.48 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $194.98 Typical High $954.99 | Professional | 54 · Surgery only | $151.36 | $194.98 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.90 Typical High $194.98 | Professional | 55 · Aftercare only | $30.20 | $38.90 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.70 Typical High $128.82 | Professional | 56 · Pre-op care only | $19.95 | $25.70 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $181.97 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $141.25 | $181.97 | $891.25 |
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· 2nd of 51
$708
AK $912UT $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.