How much rates vary
Facilitymedian $1,230 · 10th to 90th $263 to $4,467Professionalmedian $562 · 10th to 90th $234 to $1,660
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 $295.12 Median $331.13 Typical High $14,454.40 | Facility | None | $295.12 | $331.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $2,137.96 | Professional | None | $251.19 | $331.13 | $2,137.96 |
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 $239.88 Median $812.83 Typical High $1,584.89 | Professional | None | $239.88 | $812.83 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $1,202.26 Typical High $2,344.23 | Professional | 50 · Both sides | $363.08 | $1,202.26 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $537.03 Typical High $977.24 | Facility | None | $229.09 | $537.03 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $478.63 Typical High $1,047.13 | Professional | None | $177.83 | $478.63 | $1,047.13 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $5,011.87 Typical High $9,332.54 | Facility | None | $251.19 | $5,011.87 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $707.95 | Professional | None | $389.05 | $562.34 | $707.95 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $851.14 Typical High $1,778.28 | Professional | None | $263.03 | $851.14 | $1,778.28 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $891.25 | Professional | None | $489.78 | $537.03 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $316.23 Typical High $478.63 | Facility | None | $218.78 | $316.23 | $478.63 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $1,047.13 | Professional | None | $281.84 | $537.03 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $831.76 | Facility | None | $223.87 | $338.84 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $416.87 Typical High $489.78 | Professional | None | $158.49 | $416.87 | $489.78 |
Security Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,000.00 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $2,344.23 | Professional | None | $912.01 | $1,548.82 | $2,344.23 |
The Alliance Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $1,096.48 | Professional | None | $229.09 | $489.78 | $1,096.48 |
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 $147.91 Median $147.91 Typical High $165.96 | Facility | 52 · Reduced service | $147.91 | $147.91 | $165.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $66.07 | Facility | 53 · Discontinued | $58.88 | $58.88 | $66.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $251.19 | Facility | 54 · Surgery only | $218.78 | $218.78 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $50.12 | Facility | 55 · Aftercare only | $43.65 | $43.65 | $50.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $33.11 | Facility | 56 · Pre-op care only | $29.51 | $29.51 | $33.11 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $165.96 Typical High $1,071.52 | Professional | 52 · Reduced service | $147.91 | $165.96 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $66.07 Typical High $426.58 | Professional | 53 · Discontinued | $58.88 | $66.07 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $251.19 Typical High $1,621.81 | Professional | 54 · Surgery only | $218.78 | $251.19 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $323.59 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $213.80 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $234.42 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $204.17 | $234.42 | $1,513.56 |
Where Wisconsin sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 2nd of 51
$692
AK $871FL $204
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.