How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,023 to $8,128Professionalmedian $1,622 · 10th to 90th $550 to $4,266
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 $794.33 Median $8,317.64 Typical High $14,454.40 | Facility | None | $794.33 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $6,025.60 | Professional | None | $794.33 | $794.33 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,949.84 Typical High $4,265.80 | Professional | None | $562.34 | $1,949.84 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $2,951.21 Typical High $6,309.57 | Professional | 50 · Both sides | $851.14 | $2,951.21 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,202.26 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,122.02 Typical High $2,137.96 | Professional | None | $416.87 | $1,122.02 | $2,137.96 |
DeanCare Setting Facility Modifier None Typical Low $691.83 Median $7,762.47 Typical High $14,125.38 | Facility | None | $691.83 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,412.54 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $8,317.64 | Facility | None | $933.25 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,778.28 Typical High $4,265.80 | Professional | None | $575.44 | $1,778.28 | $4,265.80 |
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 $1,202.26 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,202.26 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $1,071.52 | Facility | None | $630.96 | $870.96 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,148.15 Typical High $1,819.70 | Professional | None | $549.54 | $1,148.15 | $1,819.70 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,311.31 | Facility | None | $933.25 | $1,995.26 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $416.87 Median $1,122.02 Typical High $1,258.93 | Professional | None | $416.87 | $1,122.02 | $1,258.93 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $5,623.41 | Professional | None | $2,089.30 | $3,630.78 | $5,623.41 |
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 $501.19 Median $1,148.15 Typical High $2,570.40 | Professional | None | $501.19 | $1,148.15 | $2,570.40 |
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 $398.11 Median $398.11 Typical High $2,951.21 | Professional | 52 · Reduced service | $398.11 | $398.11 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $1,202.26 | Professional | 53 · Discontinued | $158.49 | $158.49 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $4,466.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $891.25 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $602.56 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $4,168.69 |
Where Wisconsin sits
The same service costs 8.5 times more in Wyoming 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
$1,950
WY $2,512UT $295
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.