How much rates vary
Facilitymedian $1,585 · 10th to 90th $200 to $4,365Professionalmedian $380 · 10th to 90th $166 to $813
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 $117.49 Median $169.82 Typical High $14,454.40 | Facility | None | $117.49 | $169.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $1,000.00 | Professional | None | $117.49 | $169.82 | $1,000.00 |
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 $181.97 Median $416.87 Typical High $776.25 | Professional | None | $181.97 | $416.87 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $630.96 Typical High $1,174.90 | Professional | 50 · Both sides | $269.15 | $630.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $575.44 | Facility | None | $50.12 | $338.84 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $630.96 | Professional | None | $169.82 | $275.42 | $630.96 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $2,630.27 Typical High $5,128.61 | Facility | None | $138.04 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $602.56 | Professional | None | $269.15 | $389.05 | $602.56 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $1,412.54 Typical High $3,019.95 | Facility | None | $213.80 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $575.44 Typical High $1,000.00 | Professional | None | $208.93 | $575.44 | $1,000.00 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $562.34 | Professional | None | $269.15 | $426.58 | $562.34 |
Prevea360 Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $354.81 | Facility | None | $114.82 | $173.78 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $645.65 | Professional | None | $213.80 | $407.38 | $645.65 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $371.54 | Facility | None | $50.12 | $245.47 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $380.19 | Professional | None | $169.82 | $251.19 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $524.81 | Professional | None | $338.84 | $338.84 | $524.81 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $1,047.13 | Professional | None | $398.11 | $707.95 | $1,047.13 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $794.33 | Professional | None | $154.88 | $389.05 | $794.33 |
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 $57.54 Median $57.54 Typical High $85.11 | Facility | 52 · Reduced service | $57.54 | $57.54 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $33.88 | Facility | 53 · Discontinued | $23.44 | $23.44 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $128.82 | Facility | 54 · Surgery only | $87.10 | $87.10 | $128.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $25.70 | Facility | 55 · Aftercare only | $17.38 | $17.38 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $16.98 | Facility | 56 · Pre-op care only | $11.75 | $11.75 | $16.98 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $81.28 Typical High $120.23 | Facility | 78 · Unplanned return to OR | $81.28 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $85.11 Typical High $512.86 | Professional | 52 · Reduced service | $57.54 | $85.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.88 Typical High $204.17 | Professional | 53 · Discontinued | $23.44 | $33.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $128.82 Typical High $758.58 | Professional | 54 · Surgery only | $87.10 | $128.82 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $25.70 Typical High $151.36 | Professional | 55 · Aftercare only | $17.38 | $25.70 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.98 Typical High $102.33 | Professional | 56 · Pre-op care only | $11.75 | $16.98 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $120.23 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $81.28 | $120.23 | $707.95 |
Where Wisconsin sits
The same service costs 4.1 times more in Alaska 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· 2nd of 51
$457
AK $513KY $126
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.