How much rates vary
Facilitymedian $3,162 · 10th to 90th $692 to $7,762Professionalmedian $891 · 10th to 90th $407 to $2,455
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 $407.38 Median $616.60 Typical High $14,454.40 | Facility | None | $407.38 | $616.60 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $3,630.78 | Professional | None | $407.38 | $616.60 | $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 $436.52 Median $1,023.29 Typical High $2,187.76 | Professional | None | $436.52 | $1,023.29 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $1,548.82 Typical High $3,235.94 | Professional | 50 · Both sides | $645.65 | $1,548.82 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $645.65 Typical High $1,380.38 | Professional | 62 · Two surgeons | $275.42 | $645.65 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $3,019.95 | Facility | None | $1,202.26 | $1,698.24 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $891.25 Typical High $1,479.11 | Professional | None | $331.13 | $891.25 | $1,479.11 |
DeanCare Setting Facility Modifier None Typical Low $346.74 Median $2,630.27 Typical High $5,128.61 | Facility | None | $346.74 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,258.93 | Professional | None | $549.54 | $812.83 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $2,818.38 Typical High $8,128.31 | Facility | None | $524.81 | $2,818.38 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,584.89 Typical High $3,388.44 | Professional | None | $501.19 | $1,584.89 | $3,388.44 |
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 $660.69 Median $1,023.29 Typical High $1,659.59 | Professional | None | $660.69 | $1,023.29 | $1,659.59 |
Prevea360 Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $870.96 | Facility | None | $269.15 | $501.19 | $870.96 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $1,479.11 | Professional | None | $457.09 | $851.14 | $1,479.11 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,995.26 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $575.44 Typical High $891.25 | Professional | None | $218.78 | $575.44 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,380.38 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $4,466.84 | Professional | None | $1,348.96 | $2,398.83 | $4,466.84 |
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 $354.81 Median $891.25 Typical High $2,041.74 | Professional | None | $354.81 | $891.25 | $2,041.74 |
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 $204.17 Median $204.17 Typical High $309.03 | Facility | 52 · Reduced service | $204.17 | $204.17 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $123.03 | Facility | 53 · Discontinued | $81.28 | $81.28 | $123.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $467.74 | Facility | 54 · Surgery only | $309.03 | $309.03 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $93.33 | Facility | 55 · Aftercare only | $61.66 | $61.66 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $61.66 | Facility | 56 · Pre-op care only | $40.74 | $40.74 | $61.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $436.52 | Facility | 78 · Unplanned return to OR | $288.40 | $288.40 | $436.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $309.03 Typical High $1,819.70 | Professional | 52 · Reduced service | $204.17 | $309.03 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $123.03 Typical High $724.44 | Professional | 53 · Discontinued | $81.28 | $123.03 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $467.74 Typical High $2,754.23 | Professional | 54 · Surgery only | $309.03 | $467.74 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $93.33 Typical High $549.54 | Professional | 55 · Aftercare only | $61.66 | $93.33 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $61.66 Typical High $363.08 | Professional | 56 · Pre-op care only | $40.74 | $61.66 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $436.52 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $288.40 | $436.52 | $2,570.40 |
Where Wisconsin sits
The same service costs 5.5 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· 3rd of 51
$1,122
AK $1,585UT $288
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.