How much rates vary
Facilitymedian $1,585 · 10th to 90th $372 to $4,677Professionalmedian $692 · 10th to 90th $302 to $2,138
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 $338.84 Median $426.58 Typical High $14,454.40 | Facility | None | $338.84 | $426.58 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $2,691.53 | Professional | None | $338.84 | $426.58 | $2,691.53 |
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 $302.00 Median $891.25 Typical High $1,862.09 | Professional | None | $302.00 | $891.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $1,318.26 Typical High $2,754.23 | Professional | 50 · Both sides | $457.09 | $1,318.26 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $1,096.48 | Facility | None | $309.03 | $562.34 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $602.56 Typical High $1,096.48 | Professional | None | $223.87 | $602.56 | $1,096.48 |
DeanCare Setting Facility Modifier None Typical Low $295.12 Median $5,011.87 Typical High $9,332.54 | Facility | None | $295.12 | $5,011.87 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $851.14 | Professional | None | $457.09 | $660.69 | $851.14 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,412.54 Typical High $3,019.95 | Facility | None | $371.54 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $1,096.48 Typical High $3,311.31 | Professional | None | $346.74 | $1,096.48 | $3,311.31 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,122.02 | Professional | None | $602.56 | $724.44 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $275.42 Median $363.08 Typical High $602.56 | Facility | None | $275.42 | $363.08 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $1,071.52 | Professional | None | $338.84 | $645.65 | $1,071.52 |
Quartz Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $831.76 | Facility | None | $302.00 | $416.87 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $181.97 Median $489.78 Typical High $602.56 | Professional | None | $181.97 | $489.78 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,905.46 | $3,019.95 |
The Alliance Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $812.83 | Professional | None | $194.98 | $194.98 | $812.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $616.60 Typical High $1,412.54 | Professional | None | $288.40 | $616.60 | $1,412.54 |
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 $169.82 Median $169.82 Typical High $213.80 | Facility | 52 · Reduced service | $169.82 | $169.82 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $85.11 | Facility | 53 · Discontinued | $69.18 | $69.18 | $85.11 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $316.23 | Facility | 54 · Surgery only | $257.04 | $257.04 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $63.10 | Facility | 55 · Aftercare only | $51.29 | $51.29 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $42.66 | Facility | 56 · Pre-op care only | $33.88 | $33.88 | $42.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $239.88 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $213.80 Typical High $1,348.96 | Professional | 52 · Reduced service | $169.82 | $213.80 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $537.03 | Professional | 53 · Discontinued | $69.18 | $85.11 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $316.23 Typical High $2,041.74 | Professional | 54 · Surgery only | $257.04 | $316.23 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $63.10 Typical High $407.38 | Professional | 55 · Aftercare only | $51.29 | $63.10 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $42.66 Typical High $269.15 | Professional | 56 · Pre-op care only | $33.88 | $42.66 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $295.12 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $239.88 | $295.12 | $1,905.46 |
Where Wisconsin sits
The same service costs 5.2 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
$813
AK $1,000UT $191
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.