How much rates vary
Facilitymedian $2,884 · 10th to 90th $603 to $6,026Professionalmedian $537 · 10th to 90th $204 to $1,072
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 $204.17 Median $3,090.30 Typical High $14,454.40 | Facility | None | $204.17 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $1,584.89 | Professional | None | $181.97 | $204.17 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $616.60 Typical High $1,122.02 | Professional | None | $223.87 | $616.60 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,288.25 Typical High $3,162.28 | Facility | None | $467.74 | $1,288.25 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $616.60 | Professional | None | $245.47 | $389.05 | $616.60 |
DeanCare Setting Facility Modifier None Typical Low $194.98 Median $3,235.94 Typical High $5,888.44 | Facility | None | $194.98 | $3,235.94 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $537.03 | Professional | None | $316.23 | $478.63 | $537.03 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,398.83 Typical High $6,309.57 | Facility | None | $489.78 | $2,398.83 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $501.19 Typical High $870.96 | Professional | None | $194.98 | $501.19 | $870.96 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $524.81 | Professional | None | $263.03 | $446.68 | $524.81 |
Prevea360 Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $363.08 | Facility | None | $162.18 | $208.93 | $363.08 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $776.25 | Professional | None | $177.83 | $407.38 | $776.25 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,630.78 | Facility | None | $812.83 | $2,290.87 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $512.86 | Professional | None | $269.15 | $269.15 | $512.86 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $891.25 Typical High $1,023.29 | Professional | None | $446.68 | $891.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $158.49 Median $457.09 Typical High $758.58 | Professional | None | $158.49 | $457.09 | $758.58 |
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 $102.33 Median $102.33 Typical High $794.33 | Professional | 52 · Reduced service | $102.33 | $102.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $316.23 | Professional | 53 · Discontinued | $40.74 | $40.74 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $1,174.90 | Professional | 54 · Surgery only | $154.88 | $154.88 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $239.88 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $158.49 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $1,096.48 |
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· 5th of 51
$708
OK $1,349UT $155
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.