How much rates vary
Facilitymedian $4,169 · 10th to 90th $891 to $8,128Professionalmedian $1,259 · 10th to 90th $468 to $2,291
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 $467.74 Median $6,456.54 Typical High $14,454.40 | Facility | None | $467.74 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $3,388.44 | Professional | None | $467.74 | $467.74 | $3,388.44 |
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 $512.86 Median $1,380.38 Typical High $2,511.89 | Professional | None | $512.86 | $1,380.38 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $2,089.30 Typical High $3,548.13 | Professional | 50 · Both sides | $758.58 | $2,089.30 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $4,365.16 | Facility | None | $954.99 | $1,819.70 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,479.11 | Professional | None | $562.34 | $870.96 | $1,479.11 |
DeanCare Setting Facility Modifier None Typical Low $478.63 Median $4,365.16 Typical High $7,762.47 | Facility | None | $478.63 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,348.96 | Professional | None | $741.31 | $1,096.48 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $3,388.44 Typical High $8,912.51 | Facility | None | $691.83 | $3,388.44 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,288.25 Typical High $2,137.96 | Professional | None | $467.74 | $1,288.25 | $2,137.96 |
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 $602.56 Median $1,047.13 Typical High $1,348.96 | Professional | None | $602.56 | $1,047.13 | $1,348.96 |
Prevea360 Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $812.83 | Facility | None | $446.68 | $537.03 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $416.87 Median $954.99 Typical High $1,778.28 | Professional | None | $416.87 | $954.99 | $1,778.28 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $4,786.30 | Facility | None | $758.58 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,288.25 | Professional | None | $562.34 | $562.34 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,862.09 | $2,089.30 |
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 $398.11 Median $1,122.02 Typical High $2,089.30 | Professional | None | $398.11 | $1,122.02 | $2,089.30 |
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 $234.42 Median $234.42 Typical High $1,698.24 | Professional | 52 · Reduced service | $234.42 | $234.42 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $676.08 | Professional | 53 · Discontinued | $93.33 | $93.33 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $2,570.40 | Professional | 54 · Surgery only | $354.81 | $354.81 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $512.86 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $338.84 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $2,398.83 |
Where Wisconsin sits
The same service costs 6.0 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
$1,549
OK $1,862UT $309
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.