How much rates vary
Facilitymedian $3,631 · 10th to 90th $708 to $8,128Professionalmedian $977 · 10th to 90th $427 to $1,585
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 $426.58 Median $489.78 Typical High $14,454.40 | Facility | None | $426.58 | $489.78 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $3,019.95 | Professional | None | $389.05 | $489.78 | $3,019.95 |
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 $436.52 Median $1,071.52 Typical High $1,479.11 | Professional | None | $436.52 | $1,071.52 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $4,365.16 | Facility | None | $1,071.52 | $1,819.70 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,380.38 | Professional | None | $501.19 | $660.69 | $1,380.38 |
DeanCare Setting Facility Modifier None Typical Low $426.58 Median $2,570.40 Typical High $4,786.30 | Facility | None | $426.58 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,258.93 | Professional | None | $707.95 | $1,000.00 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $8,709.64 | Facility | None | $691.83 | $2,818.38 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,148.15 Typical High $2,691.53 | Professional | None | $457.09 | $1,148.15 | $2,691.53 |
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 $588.84 Median $1,000.00 Typical High $1,148.15 | Professional | None | $588.84 | $1,000.00 | $1,148.15 |
Prevea360 Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $812.83 | Facility | None | $371.54 | $478.63 | $812.83 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $1,000.00 Typical High $1,513.56 | Professional | None | $489.78 | $1,000.00 | $1,513.56 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $4,786.30 | Facility | None | $1,071.52 | $3,162.28 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,000.00 | Professional | None | $501.19 | $575.44 | $1,000.00 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | None | $660.69 | $660.69 | $758.58 |
Security Health Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,380.38 | Professional | None | $691.83 | $1,096.48 | $1,380.38 |
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 $416.87 Median $1,047.13 Typical High $1,698.24 | Professional | None | $416.87 | $1,047.13 | $1,698.24 |
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 $213.80 Median $213.80 Typical High $245.47 | Facility | 52 · Reduced service | $213.80 | $213.80 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $97.72 | Facility | 53 · Discontinued | $85.11 | $85.11 | $97.72 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $363.08 | Facility | 54 · Surgery only | $316.23 | $316.23 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $72.44 | Facility | 55 · Aftercare only | $63.10 | $63.10 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $48.98 | Facility | 56 · Pre-op care only | $42.66 | $42.66 | $48.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $338.84 | Facility | 78 · Unplanned return to OR | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $245.47 Typical High $1,513.56 | Professional | 52 · Reduced service | $213.80 | $245.47 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $602.56 | Professional | 53 · Discontinued | $85.11 | $97.72 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $2,238.72 | Professional | 54 · Surgery only | $316.23 | $363.08 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $446.68 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $302.00 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $338.84 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $295.12 | $338.84 | $2,089.30 |
Where Wisconsin sits
The same service costs 3.8 times more in Alaska 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· 2nd of 51
$1,122
AK $1,349UT $355
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.