How much rates vary
Facilitymedian $2,754 · 10th to 90th $363 to $5,754Professionalmedian $347 · 10th to 90th $151 to $912
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 $154.88 Median $245.47 Typical High $14,454.40 | Facility | None | $154.88 | $245.47 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $977.24 | Professional | None | $154.88 | $199.53 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $389.05 Typical High $831.76 | Professional | None | $162.18 | $389.05 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $588.84 Typical High $1,230.27 | Professional | 50 · Both sides | $245.47 | $588.84 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $3,162.28 | Facility | None | $478.63 | $891.25 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $346.74 Typical High $575.44 | Professional | None | $128.82 | $346.74 | $575.44 |
DeanCare Setting Facility Modifier None Typical Low $131.83 Median $2,570.40 Typical High $4,786.30 | Facility | None | $131.83 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $489.78 | Professional | None | $204.17 | $309.03 | $489.78 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $2,187.76 Typical High $6,309.57 | Facility | None | $309.03 | $2,187.76 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $602.56 Typical High $1,318.26 | Professional | None | $181.97 | $602.56 | $1,318.26 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $602.56 | Professional | None | $245.47 | $363.08 | $602.56 |
Prevea360 Setting Facility Modifier None Typical Low $102.33 Median $194.98 Typical High $363.08 | Facility | None | $102.33 | $194.98 | $363.08 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $575.44 | Professional | None | $173.78 | $331.13 | $575.44 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $2,089.30 Typical High $3,467.37 | Facility | None | $537.03 | $2,089.30 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $346.74 | Professional | None | $81.28 | $218.78 | $346.74 |
Security Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $851.14 | Professional | None | $512.86 | $512.86 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $1,737.80 | Professional | None | $478.63 | $891.25 | $1,737.80 |
The Alliance Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $131.83 Median $331.13 Typical High $741.31 | Professional | None | $131.83 | $331.13 | $741.31 |
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 $77.62 Median $77.62 Typical High $120.23 | Facility | 52 · Reduced service | $77.62 | $77.62 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $48.98 | Facility | 53 · Discontinued | $30.90 | $30.90 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $181.97 | Facility | 54 · Surgery only | $114.82 | $114.82 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $36.31 | Facility | 55 · Aftercare only | $22.91 | $22.91 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $24.55 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $24.55 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $107.15 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $120.23 Typical High $489.78 | Professional | 52 · Reduced service | $77.62 | $120.23 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $48.98 Typical High $194.98 | Professional | 53 · Discontinued | $30.90 | $48.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $741.31 | Professional | 54 · Surgery only | $114.82 | $181.97 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $147.91 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $24.55 Typical High $97.72 | Professional | 56 · Pre-op care only | $15.49 | $24.55 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $169.82 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $107.15 | $169.82 | $691.83 |
Where Wisconsin sits
The same service costs 4.8 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· 3rd of 51
$437
AK $603KY $126
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.