How much rates vary
Facilitymedian $1,318 · 10th to 90th $282 to $4,365Professionalmedian $851 · 10th to 90th $347 to $2,239
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 $346.74 Median $588.84 Typical High $14,454.40 | Facility | None | $346.74 | $588.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $588.84 Typical High $2,884.03 | Professional | None | $346.74 | $588.84 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $912.01 Typical High $1,862.09 | Professional | None | $371.54 | $912.01 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $1,380.38 Typical High $2,818.38 | Professional | 50 · Both sides | $562.34 | $1,380.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $436.52 Typical High $1,348.96 | Facility | None | $50.12 | $436.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $812.83 Typical High $1,412.54 | Professional | None | $302.00 | $812.83 | $1,412.54 |
DeanCare Setting Facility Modifier None Typical Low $380.19 Median $4,265.80 Typical High $7,762.47 | Facility | None | $380.19 | $4,265.80 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,174.90 | Professional | None | $467.74 | $758.58 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $912.01 Typical High $1,862.09 | Facility | None | $218.78 | $912.01 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,513.56 Typical High $4,168.69 | Professional | None | $467.74 | $1,513.56 | $4,168.69 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,584.89 | Professional | None | $575.44 | $954.99 | $1,584.89 |
Prevea360 Setting Facility Modifier None Typical Low $281.84 Median $467.74 Typical High $831.76 | Facility | None | $281.84 | $467.74 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $380.19 Median $812.83 Typical High $1,412.54 | Professional | None | $380.19 | $812.83 | $1,412.54 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $323.59 Typical High $524.81 | Facility | None | $50.12 | $323.59 | $524.81 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $501.19 Typical High $851.14 | Professional | None | $186.21 | $501.19 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,174.90 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,258.93 | $2,041.74 | $4,265.80 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $309.03 Median $831.76 Typical High $1,995.26 | Professional | None | $309.03 | $831.76 | $1,995.26 |
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 $173.78 Median $173.78 Typical High $295.12 | Facility | 52 · Reduced service | $173.78 | $173.78 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $117.49 | Facility | 53 · Discontinued | $69.18 | $69.18 | $117.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $446.68 | Facility | 54 · Surgery only | $263.03 | $263.03 | $446.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $89.13 | Facility | 55 · Aftercare only | $52.48 | $52.48 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $58.88 | Facility | 56 · Pre-op care only | $34.67 | $34.67 | $58.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $416.87 | Facility | 78 · Unplanned return to OR | $245.47 | $245.47 | $416.87 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $295.12 Typical High $1,412.54 | Professional | 52 · Reduced service | $173.78 | $295.12 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $117.49 Typical High $575.44 | Professional | 53 · Discontinued | $69.18 | $117.49 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $446.68 Typical High $2,137.96 | Professional | 54 · Surgery only | $263.03 | $446.68 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $89.13 Typical High $426.58 | Professional | 55 · Aftercare only | $52.48 | $89.13 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $58.88 Typical High $288.40 | Professional | 56 · Pre-op care only | $34.67 | $58.88 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $416.87 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $245.47 | $416.87 | $1,995.26 |
Where Wisconsin sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$891
AK $1,023MD $302
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.