How much rates vary
Facilitymedian $3,467 · 10th to 90th $417 to $7,943Professionalmedian $617 · 10th to 90th $275 to $1,738
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 $275.42 Median $416.87 Typical High $14,454.40 | Facility | None | $275.42 | $416.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $2,344.23 | Professional | None | $275.42 | $416.87 | $2,344.23 |
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 $275.42 Median $758.58 Typical High $1,479.11 | Professional | None | $275.42 | $758.58 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $1,148.15 Typical High $2,238.72 | Professional | 50 · Both sides | $416.87 | $1,148.15 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,288.25 | Facility | None | $398.11 | $758.58 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $602.56 Typical High $1,348.96 | Professional | None | $223.87 | $602.56 | $1,348.96 |
DeanCare Setting Facility Modifier None Typical Low $239.88 Median $5,011.87 Typical High $9,332.54 | Facility | None | $239.88 | $5,011.87 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $851.14 | Professional | None | $371.54 | $562.34 | $851.14 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $2,511.89 Typical High $8,128.31 | Facility | None | $380.19 | $2,511.89 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $1,174.90 Typical High $3,235.94 | Professional | None | $346.74 | $1,174.90 | $3,235.94 |
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 $549.54 Median $741.31 Typical High $1,148.15 | Professional | None | $549.54 | $741.31 | $1,148.15 |
Prevea360 Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $562.34 | Facility | None | $223.87 | $338.84 | $562.34 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $1,348.96 | Professional | None | $316.23 | $588.84 | $1,348.96 |
Quartz Setting Facility Modifier None Typical Low $389.05 Median $602.56 Typical High $1,288.25 | Facility | None | $389.05 | $602.56 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $147.91 Median $398.11 Typical High $602.56 | Professional | None | $147.91 | $398.11 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,479.11 | Professional | None | $933.25 | $933.25 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,621.81 | $3,019.95 |
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 $251.19 Median $588.84 Typical High $1,348.96 | Professional | None | $251.19 | $588.84 | $1,348.96 |
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 $138.04 Median $138.04 Typical High $208.93 | Facility | 52 · Reduced service | $138.04 | $138.04 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $83.18 | Facility | 53 · Discontinued | $54.95 | $54.95 | $83.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $316.23 | Facility | 54 · Surgery only | $208.93 | $208.93 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $63.10 | Facility | 55 · Aftercare only | $41.69 | $41.69 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $41.69 | Facility | 56 · Pre-op care only | $27.54 | $27.54 | $41.69 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $194.98 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $208.93 Typical High $1,174.90 | Professional | 52 · Reduced service | $138.04 | $208.93 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $83.18 Typical High $467.74 | Professional | 53 · Discontinued | $54.95 | $83.18 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $316.23 Typical High $1,778.28 | Professional | 54 · Surgery only | $208.93 | $316.23 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $63.10 Typical High $354.81 | Professional | 55 · Aftercare only | $41.69 | $63.10 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $41.69 Typical High $234.42 | Professional | 56 · Pre-op care only | $27.54 | $41.69 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $295.12 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $194.98 | $295.12 | $1,659.59 |
Where Wisconsin sits
The same service costs 4.2 times more in Wyoming 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
$794
WY $912UT $219
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.