How much rates vary
Facilitymedian $2,512 · 10th to 90th $490 to $5,754Professionalmedian $513 · 10th to 90th $191 to $1,202
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 $190.55 Median $363.08 Typical High $14,454.40 | Facility | None | $190.55 | $363.08 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $1,380.38 | Professional | None | $190.55 | $363.08 | $1,380.38 |
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 $204.17 Median $524.81 Typical High $1,023.29 | Professional | None | $204.17 | $524.81 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $794.33 Typical High $1,513.56 | Professional | 50 · Both sides | $275.42 | $794.33 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,479.11 | Facility | None | $724.44 | $954.99 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $512.86 Typical High $1,174.90 | Professional | None | $186.21 | $512.86 | $1,174.90 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $3,090.30 Typical High $5,370.32 | Facility | None | $204.17 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $741.31 | Professional | None | $251.19 | $446.68 | $741.31 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $2,187.76 Typical High $4,786.30 | Facility | None | $407.38 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $954.99 Typical High $2,884.03 | Professional | None | $295.12 | $954.99 | $2,884.03 |
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 $309.03 Median $588.84 Typical High $977.24 | Professional | None | $309.03 | $588.84 | $977.24 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $281.84 Typical High $549.54 | Facility | None | $138.04 | $281.84 | $549.54 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $501.19 Typical High $1,174.90 | Professional | None | $208.93 | $501.19 | $1,174.90 |
Quartz Setting Facility Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,659.59 | Facility | None | $707.95 | $1,023.29 | $1,659.59 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $269.15 Typical High $524.81 | Professional | None | $102.33 | $269.15 | $524.81 |
Security Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,288.25 | Professional | None | $645.65 | $645.65 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $213.80 Median $1,202.26 Typical High $2,630.27 | Professional | None | $213.80 | $1,202.26 | $2,630.27 |
The Alliance Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,023.29 | Professional | None | $812.83 | $812.83 | $1,023.29 |
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 $165.96 Median $457.09 Typical High $1,148.15 | Professional | None | $165.96 | $457.09 | $1,148.15 |
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 $95.50 Median $95.50 Typical High $181.97 | Facility | 52 · Reduced service | $95.50 | $95.50 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $72.44 | Facility | 53 · Discontinued | $38.02 | $38.02 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $275.42 | Facility | 54 · Surgery only | $141.25 | $141.25 | $275.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $54.95 | Facility | 55 · Aftercare only | $28.18 | $28.18 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $36.31 | Facility | 56 · Pre-op care only | $19.05 | $19.05 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $131.83 Typical High $257.04 | Facility | 78 · Unplanned return to OR | $131.83 | $131.83 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $181.97 Typical High $691.83 | Professional | 52 · Reduced service | $95.50 | $181.97 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $72.44 Typical High $275.42 | Professional | 53 · Discontinued | $38.02 | $72.44 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $275.42 Typical High $1,047.13 | Professional | 54 · Surgery only | $141.25 | $275.42 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $54.95 Typical High $208.93 | Professional | 55 · Aftercare only | $28.18 | $54.95 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $36.31 Typical High $138.04 | Professional | 56 · Pre-op care only | $19.05 | $36.31 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $257.04 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $131.83 | $257.04 | $977.24 |
Where Wisconsin sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$617
AK $851VA $182
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.