How much rates vary
Facilitymedian $3,090 · 10th to 90th $589 to $7,762Professionalmedian $933 · 10th to 90th $389 to $2,570
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 $467.74 Median $602.56 Typical High $14,454.40 | Facility | None | $467.74 | $602.56 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $2,137.96 | Professional | None | $407.38 | $602.56 | $2,137.96 |
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 $389.05 Median $1,202.26 Typical High $2,511.89 | Professional | None | $389.05 | $1,202.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $1,819.70 Typical High $3,801.89 | Professional | 50 · Both sides | $588.84 | $1,819.70 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $1,584.89 | Facility | None | $489.78 | $912.01 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $1,412.54 | Professional | None | $323.59 | $851.14 | $1,412.54 |
DeanCare Setting Facility Modifier None Typical Low $398.11 Median $3,162.28 Typical High $5,888.44 | Facility | None | $398.11 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,202.26 | Professional | None | $630.96 | $912.01 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,818.38 Typical High $8,128.31 | Facility | None | $588.84 | $2,818.38 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $1,412.54 Typical High $3,235.94 | Professional | None | $446.68 | $1,412.54 | $3,235.94 |
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 $758.58 Median $870.96 Typical High $1,445.44 | Professional | None | $758.58 | $870.96 | $1,445.44 |
Prevea360 Setting Facility Modifier None Typical Low $380.19 Median $478.63 Typical High $776.25 | Facility | None | $380.19 | $478.63 | $776.25 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $933.25 Typical High $1,479.11 | Professional | None | $489.78 | $933.25 | $1,479.11 |
Quartz Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $1,288.25 | Facility | None | $489.78 | $645.65 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $251.19 Median $676.08 Typical High $851.14 | Professional | None | $251.19 | $676.08 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,584.89 | $1,584.89 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $1,023.29 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,023.29 | $2,630.27 | $4,265.80 |
The Alliance Setting Professional Modifier None Typical Low $309.03 Median $1,230.27 Typical High $2,630.27 | Professional | None | $309.03 | $1,230.27 | $2,630.27 |
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 $371.54 Median $851.14 Typical High $1,905.46 | Professional | None | $371.54 | $851.14 | $1,905.46 |
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 $234.42 Median $234.42 Typical High $302.00 | Facility | 52 · Reduced service | $234.42 | $234.42 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $120.23 | Facility | 53 · Discontinued | $95.50 | $95.50 | $120.23 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $446.68 | Facility | 54 · Surgery only | $354.81 | $354.81 | $446.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $91.20 | Facility | 55 · Aftercare only | $70.79 | $70.79 | $91.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $60.26 | Facility | 56 · Pre-op care only | $46.77 | $46.77 | $60.26 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $331.13 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $302.00 Typical High $1,071.52 | Professional | 52 · Reduced service | $234.42 | $302.00 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $426.58 | Professional | 53 · Discontinued | $95.50 | $120.23 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $1,584.89 | Professional | 54 · Surgery only | $354.81 | $446.68 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $316.23 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $60.26 Typical High $213.80 | Professional | 56 · Pre-op care only | $46.77 | $60.26 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $416.87 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $331.13 | $416.87 | $1,479.11 |
Where Wisconsin sits
The same service costs 5.0 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· 3rd of 51
$1,122
AK $1,380UT $275
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.