How much rates vary
Facilitymedian $4,169 · 10th to 90th $977 to $8,318Professionalmedian $1,413 · 10th to 90th $525 to $2,512
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 $524.81 Median $8,317.64 Typical High $14,454.40 | Facility | None | $524.81 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $4,073.80 | Professional | None | $512.86 | $524.81 | $4,073.80 |
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 $562.34 Median $1,548.82 Typical High $2,754.23 | Professional | None | $562.34 | $1,548.82 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $2,398.83 Typical High $4,265.80 | Professional | 50 · Both sides | $912.01 | $2,398.83 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $4,365.16 | Facility | None | $1,071.52 | $1,995.26 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,659.59 | Professional | None | $616.60 | $954.99 | $1,659.59 |
DeanCare Setting Facility Modifier None Typical Low $537.03 Median $5,128.61 Typical High $9,332.54 | Facility | None | $537.03 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,513.56 | Professional | None | $812.83 | $1,202.26 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $8,912.51 | Facility | None | $741.31 | $3,388.44 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,479.11 Typical High $3,630.78 | Professional | None | $524.81 | $1,479.11 | $3,630.78 |
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 $660.69 Median $1,148.15 Typical High $1,479.11 | Professional | None | $660.69 | $1,148.15 | $1,479.11 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $912.01 | Facility | None | $489.78 | $575.44 | $912.01 |
Quartz Setting Professional Modifier None Typical Low $467.74 Median $1,071.52 Typical High $1,949.84 | Professional | None | $467.74 | $1,071.52 | $1,949.84 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,786.30 | Facility | None | $933.25 | $3,162.28 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,445.44 | Professional | None | $616.60 | $616.60 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Security Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,344.23 | Professional | None | $1,412.54 | $2,041.74 | $2,344.23 |
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 $436.52 Median $1,230.27 Typical High $2,344.23 | Professional | None | $436.52 | $1,230.27 | $2,344.23 |
6 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 Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $1,995.26 | Professional | 52 · Reduced service | $263.03 | $263.03 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $812.83 | Professional | 53 · Discontinued | $104.71 | $104.71 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $3,019.95 | Professional | 54 · Surgery only | $389.05 | $389.05 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $602.56 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $407.38 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $2,818.38 |
Where Wisconsin sits
The same service costs 8.7 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
$1,698
OK $2,951UT $339
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.