How much rates vary
Facilitymedian $1,202 · 10th to 90th $148 to $3,802Professionalmedian $295 · 10th to 90th $126 to $794
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 $109.65 Median $125.89 Typical High $14,454.40 | Facility | None | $109.65 | $125.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $1,318.26 | Professional | None | $109.65 | $125.89 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $436.52 Typical High $794.33 | Professional | None | $128.82 | $436.52 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $645.65 Typical High $1,174.90 | Professional | 50 · Both sides | $190.55 | $645.65 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $707.95 | Facility | None | $144.54 | $363.08 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $562.34 | Professional | None | $199.53 | $257.04 | $562.34 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $2,570.40 Typical High $4,786.30 | Facility | None | $128.82 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $380.19 | Professional | None | $218.78 | $281.84 | $380.19 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $416.87 Typical High $575.44 | Professional | 50 · Both sides | $323.59 | $416.87 | $575.44 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $912.01 Typical High $1,778.28 | Facility | None | $147.91 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $537.03 Typical High $1,737.80 | Professional | None | $154.88 | $537.03 | $1,737.80 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $467.74 | Professional | None | $169.82 | $346.74 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $281.84 | Facility | None | $107.15 | $158.49 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $588.84 | Professional | None | $177.83 | $338.84 | $588.84 |
Quartz Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $831.76 | Facility | None | $141.25 | $218.78 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $309.03 | Professional | None | $223.87 | $257.04 | $309.03 |
Security Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | None | $407.38 | $407.38 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $912.01 | Professional | None | $407.38 | $691.83 | $912.01 |
The Alliance Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $645.65 | Professional | None | $138.04 | $234.42 | $645.65 |
16 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 $53.70 Median $53.70 Typical High $63.10 | Facility | 52 · Reduced service | $53.70 | $53.70 | $63.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $25.12 | Facility | 53 · Discontinued | $21.88 | $21.88 | $25.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $93.33 | Facility | 54 · Surgery only | $81.28 | $81.28 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $19.05 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.59 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $12.59 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $87.10 | Facility | 78 · Unplanned return to OR | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $63.10 Typical High $758.58 | Professional | 52 · Reduced service | $53.70 | $63.10 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.12 Typical High $302.00 | Professional | 53 · Discontinued | $21.88 | $25.12 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $1,122.02 | Professional | 54 · Surgery only | $81.28 | $93.33 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $223.87 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.59 Typical High $151.36 | Professional | 56 · Pre-op care only | $10.96 | $12.59 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $87.10 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $75.86 | $87.10 | $1,047.13 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $107.15 Median $141.25 Typical High $190.55 | Professional | 51 · Multiple procedures | $107.15 | $141.25 | $190.55 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $223.87 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $223.87 | $309.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $75.86 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $75.86 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $234.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $181.97 | $234.42 | $323.59 |
Where Wisconsin sits
The same service costs 4.2 times more in Alaska than in Florida. 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
$347
AK $490FL $117
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.