How much rates vary
Facilitymedian $3,090 · 10th to 90th $182 to $7,762Professionalmedian $398 · 10th to 90th $151 to $813
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 $186.21 Typical High $14,454.40 | Facility | None | $125.89 | $186.21 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $1,071.52 | Professional | None | $125.89 | $186.21 | $1,071.52 |
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 $177.83 Median $478.63 Typical High $954.99 | Professional | None | $177.83 | $478.63 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $436.52 Typical High $1,023.29 | Facility | None | $151.36 | $436.52 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $575.44 | Professional | None | $169.82 | $245.47 | $575.44 |
DeanCare Setting Facility Modifier None Typical Low $131.83 Median $2,630.27 Typical High $5,128.61 | Facility | None | $131.83 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $446.68 | Professional | None | $239.88 | $354.81 | $446.68 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $2,818.38 Typical High $8,128.31 | Facility | None | $194.98 | $2,818.38 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $416.87 Typical High $831.76 | Professional | None | $165.96 | $416.87 | $831.76 |
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 $239.88 Median $323.59 Typical High $489.78 | Professional | None | $239.88 | $323.59 | $489.78 |
Prevea360 Setting Facility Modifier None Typical Low $120.23 Median $181.97 Typical High $269.15 | Facility | None | $120.23 | $181.97 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $181.97 Median $354.81 Typical High $537.03 | Professional | None | $181.97 | $354.81 | $537.03 |
Quartz Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $1,288.25 | Facility | None | $151.36 | $229.09 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $323.59 | Professional | None | $169.82 | $245.47 | $323.59 |
Security Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | None | $275.42 | $275.42 | $426.58 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $912.01 | Professional | None | $338.84 | $602.56 | $912.01 |
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 $141.25 Median $363.08 Typical High $602.56 | Professional | None | $141.25 | $363.08 | $602.56 |
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 $93.33 | Facility | 52 · Reduced service | $63.10 | $63.10 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $37.15 | Facility | 53 · Discontinued | $25.70 | $25.70 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $141.25 | Facility | 54 · Surgery only | $95.50 | $95.50 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $28.18 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $18.62 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $18.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $131.83 | Facility | 78 · Unplanned return to OR | $89.13 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $93.33 Typical High $537.03 | Professional | 52 · Reduced service | $63.10 | $93.33 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $213.80 | Professional | 53 · Discontinued | $25.70 | $37.15 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $794.33 | Professional | 54 · Surgery only | $95.50 | $141.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $158.49 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.62 Typical High $107.15 | Professional | 56 · Pre-op care only | $12.59 | $18.62 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $741.31 |
Where Wisconsin sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 1st of 51
$468
WI $468TX $129
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.