How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,175 to $14,125Professionalmedian $2,344 · 10th to 90th $617 to $9,120
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 $616.60 Median $2,818.38 Typical High $14,454.40 | Facility | None | $616.60 | $2,818.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $2,818.38 Typical High $28,183.83 | Professional | None | $616.60 | $2,818.38 | $28,183.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,311.31 | Professional | None | $645.65 | $1,698.24 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $2,511.89 Typical High $4,897.79 | Professional | 50 · Both sides | $977.24 | $2,511.89 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $6,309.57 Typical High $9,549.93 | Facility | None | $954.99 | $6,309.57 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,621.81 Typical High $6,918.31 | Professional | None | $630.96 | $1,621.81 | $6,918.31 |
DeanCare Setting Facility Modifier None Typical Low $660.69 Median $2,818.38 Typical High $5,128.61 | Facility | None | $660.69 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $5,623.41 | Professional | None | $812.83 | $1,445.44 | $5,623.41 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,754.40 Typical High $13,489.63 | Facility | None | $912.01 | $5,754.40 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $7,762.47 Typical High $15,488.17 | Professional | None | $2,454.71 | $7,762.47 | $15,488.17 |
Network Health Setting Facility Modifier None Typical Low $4,073.80 Median $9,549.93 Typical High $15,848.93 | Facility | None | $4,073.80 | $9,549.93 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $7,943.28 | Professional | None | $1,096.48 | $2,818.38 | $7,943.28 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $4,265.80 | Facility | None | $489.78 | $912.01 | $4,265.80 |
Quartz Setting Professional Modifier None Typical Low $676.08 Median $2,344.23 Typical High $8,128.31 | Professional | None | $676.08 | $2,344.23 | $8,128.31 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $9,772.37 | Facility | None | $758.58 | $5,888.44 | $9,772.37 |
Quartz Setting Professional Modifier None Typical Low $323.59 Median $1,513.56 Typical High $3,981.07 | Professional | None | $323.59 | $1,513.56 | $3,981.07 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $10,471.29 | Professional | None | $2,089.30 | $2,089.30 | $10,471.29 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $8,128.31 Typical High $20,892.96 | Professional | None | $2,290.87 | $8,128.31 | $20,892.96 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $512.86 Median $2,137.96 Typical High $9,772.37 | Professional | None | $512.86 | $2,137.96 | $9,772.37 |
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 $309.03 Median $309.03 Typical High $1,412.54 | Facility | 52 · Reduced service | $309.03 | $309.03 | $1,412.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $562.34 | Facility | 53 · Discontinued | $123.03 | $123.03 | $562.34 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $2,137.96 | Facility | 54 · Surgery only | $457.09 | $457.09 | $2,137.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $426.58 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $426.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $281.84 | Facility | 56 · Pre-op care only | $61.66 | $61.66 | $281.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $1,995.26 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $1,995.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $1,412.54 Typical High $13,803.84 | Professional | 52 · Reduced service | $309.03 | $1,412.54 | $13,803.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $562.34 Typical High $5,623.41 | Professional | 53 · Discontinued | $123.03 | $562.34 | $5,623.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $2,137.96 Typical High $20,892.96 | Professional | 54 · Surgery only | $457.09 | $2,137.96 | $20,892.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $426.58 Typical High $4,168.69 | Professional | 55 · Aftercare only | $91.20 | $426.58 | $4,168.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $281.84 Typical High $2,818.38 | Professional | 56 · Pre-op care only | $61.66 | $281.84 | $2,818.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $1,995.26 Typical High $19,498.45 | Professional | 78 · Unplanned return to OR | $426.58 | $1,995.26 | $19,498.45 |
Where Wisconsin sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 4th of 51
$2,818
AK $4,898KY $501
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.