How much rates vary
Facilitymedian $2,344 · 10th to 90th $324 to $5,623Professionalmedian $389 · 10th to 90th $135 to $1,047
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 $134.90 Median $323.59 Typical High $14,454.40 | Facility | None | $134.90 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $323.59 Typical High $1,737.80 | Professional | None | $134.90 | $323.59 | $1,737.80 |
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 $144.54 Median $371.54 Typical High $724.44 | Professional | None | $144.54 | $371.54 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $562.34 Typical High $1,096.48 | Professional | 50 · Both sides | $213.80 | $562.34 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $616.60 Typical High $977.24 | Facility | None | $338.84 | $616.60 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $398.11 Typical High $1,071.52 | Professional | None | $141.25 | $398.11 | $1,071.52 |
DeanCare Setting Facility Modifier None Typical Low $114.82 Median $2,630.27 Typical High $5,128.61 | Facility | None | $114.82 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $660.69 | Professional | None | $181.97 | $316.23 | $660.69 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $2,041.74 Typical High $4,365.16 | Facility | None | $263.03 | $2,041.74 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $812.83 Typical High $1,949.84 | Professional | None | $251.19 | $812.83 | $1,949.84 |
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 $218.78 Median $426.58 Typical High $812.83 | Professional | None | $218.78 | $426.58 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $199.53 Typical High $436.52 | Facility | None | $91.20 | $199.53 | $436.52 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $426.58 Typical High $1,047.13 | Professional | None | $154.88 | $426.58 | $1,047.13 |
Quartz Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $831.76 | Facility | None | $331.13 | $446.68 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $194.98 Typical High $467.74 | Professional | None | $72.44 | $194.98 | $467.74 |
Security Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $1,174.90 | Professional | None | $457.09 | $457.09 | $1,174.90 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $954.99 Typical High $2,344.23 | Professional | None | $186.21 | $954.99 | $2,344.23 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $4,677.35 | Facility | None | $707.95 | $2,754.23 | $4,677.35 |
United Setting Professional Modifier None Typical Low $117.49 Median $338.84 Typical High $1,000.00 | Professional | None | $117.49 | $338.84 | $1,000.00 |
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 $67.61 Median $67.61 Typical High $162.18 | Facility | 52 · Reduced service | $67.61 | $67.61 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $64.57 | Facility | 53 · Discontinued | $26.92 | $26.92 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $245.47 | Facility | 54 · Surgery only | $102.33 | $102.33 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $48.98 | Facility | 55 · Aftercare only | $20.42 | $20.42 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $32.36 | Facility | 56 · Pre-op care only | $13.49 | $13.49 | $32.36 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $229.09 | Facility | 78 · Unplanned return to OR | $95.50 | $95.50 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $162.18 Typical High $870.96 | Professional | 52 · Reduced service | $67.61 | $162.18 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $64.57 Typical High $346.74 | Professional | 53 · Discontinued | $26.92 | $64.57 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $245.47 Typical High $1,318.26 | Professional | 54 · Surgery only | $102.33 | $245.47 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $48.98 Typical High $263.03 | Professional | 55 · Aftercare only | $20.42 | $48.98 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $32.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $13.49 | $32.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $229.09 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $95.50 | $229.09 | $1,230.27 |
Where Wisconsin sits
The same service costs 5.6 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
$468
AK $562KY $100
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.