How much rates vary
Facilitymedian $1,660 · 10th to 90th $562 to $4,677Professionalmedian $1,288 · 10th to 90th $589 to $3,890
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 $691.83 Median $724.44 Typical High $14,454.40 | Facility | None | $691.83 | $724.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $5,248.07 | Professional | None | $691.83 | $724.44 | $5,248.07 |
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 $537.03 Median $1,905.46 Typical High $3,630.78 | Professional | None | $537.03 | $1,905.46 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $2,818.38 Typical High $5,495.41 | Professional | 50 · Both sides | $812.83 | $2,818.38 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,659.59 | Facility | None | $501.19 | $812.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,047.13 Typical High $2,454.71 | Professional | None | $389.05 | $1,047.13 | $2,454.71 |
DeanCare Setting Facility Modifier None Typical Low $575.44 Median $5,495.41 Typical High $10,232.93 | Facility | None | $575.44 | $5,495.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,548.82 | Professional | None | $912.01 | $1,258.93 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $1,479.11 Typical High $3,548.13 | Facility | None | $457.09 | $1,479.11 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $2,041.74 Typical High $5,495.41 | Professional | None | $691.83 | $2,041.74 | $5,495.41 |
Network Health Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $3,235.94 | Facility | None | $954.99 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,288.25 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $1,071.52 | Facility | None | $489.78 | $741.31 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,290.87 | Professional | None | $588.84 | $1,174.90 | $2,290.87 |
Quartz Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $1,096.48 | Facility | None | $478.63 | $645.65 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $977.24 Typical High $1,096.48 | Professional | None | $363.08 | $977.24 | $1,096.48 |
Security Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,511.89 | Professional | None | $2,344.23 | $2,344.23 | $2,511.89 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $5,128.61 | Professional | None | $1,995.26 | $3,548.13 | $5,128.61 |
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 $562.34 Median $1,174.90 Typical High $2,630.27 | Professional | None | $562.34 | $1,174.90 | $2,630.27 |
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 $338.84 Median $338.84 Typical High $363.08 | Facility | 52 · Reduced service | $338.84 | $338.84 | $363.08 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Facility | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $549.54 | Facility | 54 · Surgery only | $512.86 | $512.86 | $549.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $109.65 | Facility | 55 · Aftercare only | $102.33 | $102.33 | $109.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $512.86 | Facility | 78 · Unplanned return to OR | $478.63 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $363.08 Typical High $2,630.27 | Professional | 52 · Reduced service | $338.84 | $363.08 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $1,047.13 | Professional | 53 · Discontinued | $138.04 | $144.54 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $3,890.45 | Professional | 54 · Surgery only | $512.86 | $549.54 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $776.25 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $72.44 Typical High $524.81 | Professional | 56 · Pre-op care only | $69.18 | $72.44 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $3,630.78 |
Where Wisconsin sits
The same service costs 6.2 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
$1,413
AK $1,995UT $324
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.