How much rates vary
Facilitymedian $1,202 · 10th to 90th $191 to $3,802Professionalmedian $380 · 10th to 90th $145 to $851
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 $125.89 Median $208.93 Typical High $14,454.40 | Facility | None | $125.89 | $208.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $676.08 | Professional | None | $125.89 | $173.78 | $676.08 |
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 $177.83 Median $478.63 Typical High $977.24 | Professional | None | $177.83 | $478.63 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $489.78 Typical High $831.76 | Facility | None | $186.21 | $489.78 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $645.65 | Professional | None | $165.96 | $275.42 | $645.65 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $3,090.30 Typical High $5,370.32 | Facility | None | $128.82 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $512.86 | Professional | None | $234.42 | $323.59 | $512.86 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $1,778.28 | Facility | None | $154.88 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $831.76 | Professional | None | $162.18 | $389.05 | $831.76 |
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 $204.17 Median $288.40 Typical High $549.54 | Professional | None | $204.17 | $288.40 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $380.19 | Facility | None | $112.20 | $190.55 | $380.19 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $602.56 | Professional | None | $204.17 | $354.81 | $602.56 |
Quartz Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $831.76 | Facility | None | $181.97 | $281.84 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $331.13 | Professional | None | $165.96 | $275.42 | $331.13 |
Security Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $467.74 | Professional | None | $275.42 | $275.42 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $263.03 Median $602.56 Typical High $1,023.29 | Professional | None | $263.03 | $602.56 | $1,023.29 |
The Alliance Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | None | $467.74 | $478.63 | $478.63 |
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 $120.23 Median $323.59 Typical High $562.34 | Professional | None | $120.23 | $323.59 | $562.34 |
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 $63.10 Median $63.10 Typical High $104.71 | Facility | 52 · Reduced service | $63.10 | $63.10 | $104.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $41.69 | Facility | 53 · Discontinued | $25.12 | $25.12 | $41.69 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $158.49 | Facility | 54 · Surgery only | $93.33 | $93.33 | $158.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $31.62 | Facility | 55 · Aftercare only | $18.62 | $18.62 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $20.89 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $20.89 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $147.91 | Facility | 78 · Unplanned return to OR | $87.10 | $87.10 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $104.71 Typical High $467.74 | Professional | 52 · Reduced service | $63.10 | $104.71 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $41.69 Typical High $186.21 | Professional | 53 · Discontinued | $25.12 | $41.69 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $158.49 Typical High $691.83 | Professional | 54 · Surgery only | $93.33 | $158.49 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $31.62 Typical High $138.04 | Professional | 55 · Aftercare only | $18.62 | $31.62 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.89 Typical High $93.33 | Professional | 56 · Pre-op care only | $12.59 | $20.89 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $147.91 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $87.10 | $147.91 | $645.65 |
Where Wisconsin sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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
$427
AK $457KY $126
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.