How much rates vary
Facilitymedian $3,467 · 10th to 90th $692 to $7,943Professionalmedian $933 · 10th to 90th $417 to $2,512
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 $436.52 Median $645.65 Typical High $14,454.40 | Facility | None | $436.52 | $645.65 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $2,511.89 | Professional | None | $436.52 | $645.65 | $2,511.89 |
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 $436.52 Median $1,202.26 Typical High $2,290.87 | Professional | None | $436.52 | $1,202.26 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,778.28 Typical High $3,467.37 | Professional | 50 · Both sides | $660.69 | $1,778.28 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,754.23 | Facility | None | $954.99 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $933.25 Typical High $2,089.30 | Professional | None | $346.74 | $933.25 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $4,168.69 Typical High $7,413.10 | Facility | None | $416.87 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,318.26 | Professional | None | $575.44 | $870.96 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $8,317.64 | Facility | None | $691.83 | $2,818.38 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,659.59 Typical High $3,548.13 | Professional | None | $478.63 | $1,659.59 | $3,548.13 |
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 $602.56 Median $831.76 Typical High $1,348.96 | Professional | None | $602.56 | $831.76 | $1,348.96 |
Prevea360 Setting Facility Modifier None Typical Low $288.40 Median $524.81 Typical High $831.76 | Facility | None | $288.40 | $524.81 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $2,089.30 | Professional | None | $489.78 | $912.01 | $2,089.30 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $3,162.28 | Facility | None | $758.58 | $1,995.26 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $616.60 Typical High $933.25 | Professional | None | $229.09 | $616.60 | $933.25 |
Security Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,445.44 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $741.31 Median $2,511.89 Typical High $4,677.35 | Professional | None | $741.31 | $2,511.89 | $4,677.35 |
The Alliance Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,862.09 | $1,862.09 | $2,290.87 |
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 $338.84 Median $912.01 Typical High $2,137.96 | Professional | None | $338.84 | $912.01 | $2,137.96 |
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 $213.80 Median $213.80 Typical High $323.59 | Facility | 52 · Reduced service | $213.80 | $213.80 | $323.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $128.82 | Facility | 53 · Discontinued | $87.10 | $87.10 | $128.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $489.78 | Facility | 54 · Surgery only | $323.59 | $323.59 | $489.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $97.72 | Facility | 55 · Aftercare only | $64.57 | $64.57 | $97.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $64.57 | Facility | 56 · Pre-op care only | $43.65 | $43.65 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $457.09 | Facility | 78 · Unplanned return to OR | $302.00 | $302.00 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $323.59 Typical High $1,258.93 | Professional | 52 · Reduced service | $213.80 | $323.59 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $128.82 Typical High $501.19 | Professional | 53 · Discontinued | $87.10 | $128.82 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $489.78 Typical High $1,905.46 | Professional | 54 · Surgery only | $323.59 | $489.78 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $97.72 Typical High $380.19 | Professional | 55 · Aftercare only | $64.57 | $97.72 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $64.57 Typical High $251.19 | Professional | 56 · Pre-op care only | $43.65 | $64.57 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $457.09 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $302.00 | $457.09 | $1,778.28 |
Where Wisconsin sits
The same service costs 5.9 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
$1,230
AK $1,698UT $288
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.