How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $7,943Professionalmedian $1,202 · 10th to 90th $525 to $3,631
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 $602.56 Median $758.58 Typical High $14,454.40 | Facility | None | $602.56 | $758.58 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $4,897.79 | Professional | None | $602.56 | $758.58 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,235.94 | Professional | None | $524.81 | $1,659.59 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $2,511.89 Typical High $4,786.30 | Professional | 50 · Both sides | $794.33 | $2,511.89 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,202.26 | $1,737.80 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,071.52 Typical High $2,398.83 | Professional | None | $398.11 | $1,071.52 | $2,398.83 |
DeanCare Setting Facility Modifier None Typical Low $575.44 Median $4,786.30 Typical High $8,912.51 | Facility | None | $575.44 | $4,786.30 | $8,912.51 |
DeanCare Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,513.56 | Professional | None | $812.83 | $1,174.90 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,951.21 Typical High $8,317.64 | Facility | None | $691.83 | $2,951.21 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,905.46 Typical High $4,677.35 | Professional | None | $588.84 | $1,905.46 | $4,677.35 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,995.26 | Professional | None | $977.24 | $1,202.26 | $1,995.26 |
Prevea360 Setting Facility Modifier None Typical Low $478.63 Median $616.60 Typical High $954.99 | Facility | None | $478.63 | $616.60 | $954.99 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $2,398.83 | Professional | None | $616.60 | $1,148.15 | $2,398.83 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,311.31 | Facility | None | $933.25 | $1,995.26 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $1,071.52 | Professional | None | $323.59 | $851.14 | $1,071.52 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,041.74 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $5,370.32 | Professional | None | $2,041.74 | $3,388.44 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $489.78 Median $1,096.48 Typical High $2,454.71 | Professional | None | $489.78 | $1,096.48 | $2,454.71 |
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 $302.00 Median $302.00 Typical High $380.19 | Facility | 52 · Reduced service | $302.00 | $302.00 | $380.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $151.36 | Facility | 53 · Discontinued | $120.23 | $120.23 | $151.36 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $562.34 | Facility | 54 · Surgery only | $457.09 | $457.09 | $562.34 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $112.20 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $112.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $75.86 | Facility | 56 · Pre-op care only | $60.26 | $60.26 | $75.86 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $524.81 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $380.19 Typical High $2,398.83 | Professional | 52 · Reduced service | $302.00 | $380.19 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $977.24 | Professional | 53 · Discontinued | $120.23 | $151.36 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $3,630.78 | Professional | 54 · Surgery only | $457.09 | $562.34 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $724.44 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $489.78 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $3,388.44 |
Where Wisconsin sits
The same service costs 6.5 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
$1,622
AK $2,239UT $347
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.