How much rates vary
Facilitymedian $1,202 · 10th to 90th $135 to $3,802Professionalmedian $302 · 10th to 90th $117 to $575
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 $102.33 Median $134.90 Typical High $14,454.40 | Facility | None | $102.33 | $134.90 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $724.44 | Professional | None | $102.33 | $134.90 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $363.08 Typical High $616.60 | Professional | None | $134.90 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $316.23 Typical High $707.95 | Facility | None | $134.90 | $316.23 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $426.58 | Professional | None | $120.23 | $190.55 | $426.58 |
DeanCare Setting Facility Modifier None Typical Low $97.72 Median $2,630.27 Typical High $5,128.61 | Facility | None | $97.72 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $354.81 | Professional | None | $190.55 | $275.42 | $354.81 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $1,778.28 | Facility | None | $128.82 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $354.81 Typical High $660.69 | Professional | None | $128.82 | $354.81 | $660.69 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $389.05 | Professional | None | $173.78 | $269.15 | $389.05 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $213.80 | Facility | None | $81.28 | $125.89 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $398.11 | Professional | None | $134.90 | $269.15 | $398.11 |
Quartz Setting Facility Modifier None Typical Low $131.83 Median $204.17 Typical High $831.76 | Facility | None | $131.83 | $204.17 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $288.40 | Professional | None | $120.23 | $162.18 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | None | $234.42 | $234.42 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $426.58 Typical High $575.44 | Professional | None | $257.04 | $426.58 | $575.44 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $107.15 Median $275.42 Typical High $501.19 | Professional | None | $107.15 | $275.42 | $501.19 |
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 $51.29 Median $51.29 Typical High $67.61 | Facility | 52 · Reduced service | $51.29 | $51.29 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $26.92 | Facility | 53 · Discontinued | $20.42 | $20.42 | $26.92 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $102.33 | Facility | 54 · Surgery only | $75.86 | $75.86 | $102.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $20.42 | Facility | 55 · Aftercare only | $15.14 | $15.14 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $13.49 | Facility | 56 · Pre-op care only | $10.23 | $10.23 | $13.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | 78 · Unplanned return to OR | $70.79 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $67.61 Typical High $389.05 | Professional | 52 · Reduced service | $51.29 | $67.61 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $158.49 | Professional | 53 · Discontinued | $20.42 | $26.92 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $102.33 Typical High $588.84 | Professional | 54 · Surgery only | $75.86 | $102.33 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $117.49 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $79.43 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $95.50 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $70.79 | $95.50 | $549.54 |
Where Wisconsin sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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
$347
AK $355PA $107
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.