How much rates vary
Facilitymedian $3,467 · 10th to 90th $603 to $10,471Professionalmedian $1,175 · 10th to 90th $479 to $1,738
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 $489.78 Median $3,090.30 Typical High $14,454.40 | Facility | None | $489.78 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $3,630.78 | Professional | None | $489.78 | $489.78 | $3,630.78 |
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 $512.86 Median $1,230.27 Typical High $1,737.80 | Professional | None | $512.86 | $1,230.27 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,187.76 | Facility | None | $724.44 | $1,174.90 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,412.54 | Professional | None | $575.44 | $851.14 | $1,412.54 |
DeanCare Setting Facility Modifier None Typical Low $478.63 Median $7,943.28 Typical High $14,454.40 | Facility | None | $478.63 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,288.25 | Professional | None | $724.44 | $1,071.52 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $2,454.71 Typical High $18,197.01 | Facility | None | $426.58 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,122.02 Typical High $1,862.09 | Professional | None | $467.74 | $1,122.02 | $1,862.09 |
Network Health Setting Facility Modifier None Typical Low $588.84 Median $794.33 Typical High $2,089.30 | Facility | None | $588.84 | $794.33 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,230.27 | Professional | None | $602.56 | $1,023.29 | $1,230.27 |
Prevea360 Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $831.76 | Facility | None | $371.54 | $489.78 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $912.01 Typical High $1,778.28 | Professional | None | $426.58 | $912.01 | $1,778.28 |
Quartz Setting Facility Modifier None Typical Low $575.44 Median $1,000.00 Typical High $3,090.30 | Facility | None | $575.44 | $1,000.00 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,148.15 | Professional | None | $575.44 | $575.44 | $1,148.15 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,380.38 | Professional | None | $758.58 | $1,230.27 | $1,380.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $389.05 Median $1,023.29 Typical High $1,819.70 | Professional | None | $389.05 | $1,023.29 | $1,819.70 |
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 $245.47 Median $245.47 Typical High $1,819.70 | Professional | 52 · Reduced service | $245.47 | $245.47 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $724.44 | Professional | 53 · Discontinued | $97.72 | $97.72 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $2,754.23 | Professional | 54 · Surgery only | $371.54 | $371.54 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $549.54 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $363.08 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $2,570.40 |
Where Wisconsin sits
The same service costs 6.0 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
$1,259
AK $1,380UT $229
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.