How much rates vary
Facilitymedian $2,344 · 10th to 90th $389 to $5,623Professionalmedian $468 · 10th to 90th $178 to $1,122
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 $151.36 Median $177.83 Typical High $14,454.40 | Facility | None | $151.36 | $177.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $1,584.89 | Professional | None | $151.36 | $177.83 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $524.81 Typical High $1,202.26 | Professional | None | $213.80 | $524.81 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $870.96 Typical High $1,659.59 | Facility | None | $501.19 | $870.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $645.65 | Professional | None | $251.19 | $354.81 | $645.65 |
DeanCare Setting Facility Modifier None Typical Low $173.78 Median $2,570.40 Typical High $4,786.30 | Facility | None | $173.78 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $549.54 | Professional | None | $331.13 | $467.74 | $549.54 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $2,187.76 Typical High $4,786.30 | Facility | None | $331.13 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $524.81 Typical High $1,174.90 | Professional | None | $199.53 | $524.81 | $1,174.90 |
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 $275.42 Median $446.68 Typical High $549.54 | Professional | None | $275.42 | $446.68 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $389.05 | Facility | None | $131.83 | $177.83 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $691.83 | Professional | None | $229.09 | $446.68 | $691.83 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $1,202.26 Typical High $1,905.46 | Facility | None | $537.03 | $1,202.26 | $1,905.46 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $467.74 | Professional | None | $302.00 | $354.81 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | None | $676.08 | $676.08 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,230.27 | Professional | None | $645.65 | $1,023.29 | $1,230.27 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $177.83 Median $457.09 Typical High $851.14 | Professional | None | $177.83 | $457.09 | $851.14 |
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 $75.86 Median $75.86 Typical High $89.13 | Facility | 52 · Reduced service | $75.86 | $75.86 | $89.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $35.48 | Facility | 53 · Discontinued | $30.20 | $30.20 | $35.48 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $131.83 | Facility | 54 · Surgery only | $112.20 | $112.20 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $26.30 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $17.78 | Facility | 56 · Pre-op care only | $15.14 | $15.14 | $17.78 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $104.71 Typical High $123.03 | Facility | 78 · Unplanned return to OR | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $89.13 Typical High $794.33 | Professional | 52 · Reduced service | $75.86 | $89.13 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $35.48 Typical High $323.59 | Professional | 53 · Discontinued | $30.20 | $35.48 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $131.83 Typical High $1,202.26 | Professional | 54 · Surgery only | $112.20 | $131.83 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $239.88 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.78 Typical High $158.49 | Professional | 56 · Pre-op care only | $15.14 | $17.78 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $123.03 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $104.71 | $123.03 | $1,122.02 |
Where Wisconsin sits
The same service costs 4.6 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
$589
AK $759UT $166
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.