How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,318 to $7,762Professionalmedian $2,042 · 10th to 90th $724 to $5,495
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 $1,023.29 Median $3,019.95 Typical High $14,454.40 | Facility | None | $1,023.29 | $3,019.95 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $5,011.87 | Professional | None | $1,023.29 | $1,023.29 | $5,011.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $3,981.07 Typical High $6,165.95 | Facility | None | $2,454.71 | $3,981.07 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $2,630.27 Typical High $5,495.41 | Professional | None | $758.58 | $2,630.27 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $3,981.07 Typical High $8,128.31 | Professional | 50 · Both sides | $1,148.15 | $3,981.07 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,445.44 Typical High $2,818.38 | Professional | None | $549.54 | $1,445.44 | $2,818.38 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,122.02 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,348.96 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,000.00 | $3,162.28 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $2,398.83 Typical High $5,623.41 | Professional | None | $794.33 | $2,398.83 | $5,623.41 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,621.81 | $1,621.81 | $2,691.53 |
Prevea360 Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,445.44 | Facility | None | $794.33 | $1,122.02 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $724.44 Median $1,513.56 Typical High $2,398.83 | Professional | None | $724.44 | $1,513.56 | $2,398.83 |
Quartz Setting Facility Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $3,890.45 | Facility | None | $1,445.44 | $2,344.23 | $3,890.45 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,445.44 Typical High $1,659.59 | Professional | None | $549.54 | $1,445.44 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $3,981.07 | Professional | None | $3,162.28 | $3,715.35 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $8,128.31 | Facility | None | $1,071.52 | $3,162.28 | $8,128.31 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,659.59 Typical High $3,715.35 | Professional | None | $776.25 | $1,659.59 | $3,715.35 |
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 $512.86 Median $512.86 Typical High $2,511.89 | Professional | 52 · Reduced service | $512.86 | $512.86 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $1,000.00 | Professional | 53 · Discontinued | $204.17 | $204.17 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $3,715.35 | Professional | 54 · Surgery only | $758.58 | $758.58 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $741.31 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $501.19 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $3,467.37 |
Where Wisconsin sits
The same service costs 4.6 times more in Alaska than in New York. 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
$2,512
AK $3,090NY $676
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.