How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,445 to $16,218Professionalmedian $2,344 · 10th to 90th $851 to $4,169
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 $851.14 Median $9,549.93 Typical High $14,454.40 | Facility | None | $851.14 | $9,549.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $8,317.64 | Professional | None | $851.14 | $851.14 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $2,630.27 Typical High $4,786.30 | Professional | None | $933.25 | $2,630.27 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $3,981.07 Typical High $6,918.31 | Professional | 50 · Both sides | $1,380.38 | $3,981.07 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $7,585.78 | Facility | None | $1,348.96 | $3,311.31 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,584.89 | $2,818.38 |
DeanCare Setting Facility Modifier None Typical Low $831.76 Median $8,128.31 Typical High $14,791.08 | Facility | None | $831.76 | $8,128.31 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,995.26 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $8,317.64 Typical High $15,135.61 | Facility | None | $1,230.27 | $8,317.64 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $2,454.71 Typical High $3,981.07 | Professional | None | $891.25 | $2,454.71 | $3,981.07 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,905.46 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $1,548.82 | Facility | None | $691.83 | $870.96 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $3,235.94 | Professional | None | $758.58 | $1,737.80 | $3,235.94 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $5,128.61 Typical High $8,317.64 | Facility | None | $1,071.52 | $5,128.61 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,023.29 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,238.72 | $3,388.44 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $741.31 Median $2,137.96 Typical High $3,890.45 | Professional | None | $741.31 | $2,137.96 | $3,890.45 |
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 $426.58 Median $426.58 Typical High $4,073.80 | Professional | 52 · Reduced service | $426.58 | $426.58 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $1,659.59 | Professional | 53 · Discontinued | $173.78 | $173.78 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $6,165.95 | Professional | 54 · Surgery only | $645.65 | $645.65 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $1,230.27 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $831.76 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $5,754.40 |
Where Wisconsin sits
The same service costs 7.2 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
$2,951
OK $3,890UT $537
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.