How much rates vary
Facilitymedian $2,455 · 10th to 90th $380 to $5,623Professionalmedian $537 · 10th to 90th $219 to $1,349
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 $218.78 Median $380.19 Typical High $14,454.40 | Facility | None | $218.78 | $380.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $1,513.56 | Professional | None | $218.78 | $309.03 | $1,513.56 |
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 $229.09 Median $602.56 Typical High $1,148.15 | Professional | None | $229.09 | $602.56 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $891.25 Typical High $1,737.80 | Professional | 50 · Both sides | $346.74 | $891.25 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $630.96 Typical High $1,096.48 | Facility | None | $346.74 | $630.96 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $537.03 Typical High $1,230.27 | Professional | None | $194.98 | $537.03 | $1,230.27 |
DeanCare Setting Facility Modifier None Typical Low $186.21 Median $2,630.27 Typical High $5,128.61 | Facility | None | $186.21 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $758.58 | Professional | None | $288.40 | $489.78 | $758.58 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $2,187.76 Typical High $4,365.16 | Facility | None | $426.58 | $2,187.76 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $977.24 Typical High $2,238.72 | Professional | None | $302.00 | $977.24 | $2,238.72 |
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 $354.81 Median $616.60 Typical High $1,000.00 | Professional | None | $354.81 | $616.60 | $1,000.00 |
Prevea360 Setting Facility Modifier None Typical Low $144.54 Median $275.42 Typical High $524.81 | Facility | None | $144.54 | $275.42 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $512.86 Typical High $1,230.27 | Professional | None | $239.88 | $512.86 | $1,230.27 |
Quartz Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $831.76 | Facility | None | $338.84 | $446.68 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $114.82 Median $309.03 Typical High $537.03 | Professional | None | $114.82 | $309.03 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,348.96 | Professional | None | $741.31 | $741.31 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $371.54 Median $1,380.38 Typical High $2,754.23 | Professional | None | $371.54 | $1,380.38 | $2,754.23 |
The Alliance Setting Professional Modifier None Typical Low $251.19 Median $630.96 Typical High $1,412.54 | Professional | None | $251.19 | $630.96 | $1,412.54 |
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 $190.55 Median $512.86 Typical High $1,258.93 | Professional | None | $190.55 | $512.86 | $1,258.93 |
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 $107.15 Median $107.15 Typical High $190.55 | Facility | 52 · Reduced service | $107.15 | $107.15 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $75.86 | Facility | 53 · Discontinued | $43.65 | $43.65 | $75.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $281.84 | Facility | 54 · Surgery only | $162.18 | $162.18 | $281.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $57.54 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $57.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $38.02 | Facility | 56 · Pre-op care only | $21.88 | $21.88 | $38.02 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $263.03 | Facility | 78 · Unplanned return to OR | $151.36 | $151.36 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $190.55 Typical High $812.83 | Professional | 52 · Reduced service | $107.15 | $190.55 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $75.86 Typical High $323.59 | Professional | 53 · Discontinued | $43.65 | $75.86 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $281.84 Typical High $1,230.27 | Professional | 54 · Surgery only | $162.18 | $281.84 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $57.54 Typical High $245.47 | Professional | 55 · Aftercare only | $32.36 | $57.54 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $38.02 Typical High $162.18 | Professional | 56 · Pre-op care only | $21.88 | $38.02 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $263.03 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $151.36 | $263.03 | $1,148.15 |
Where Wisconsin sits
The same service costs 3.8 times more in Wyoming 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
$617
WY $741KY $195
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.