How much rates vary
Facilitymedian $1,445 · 10th to 90th $214 to $3,802Professionalmedian $501 · 10th to 90th $186 to $1,072
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 $125.89 Median $199.53 Typical High $14,454.40 | Facility | None | $125.89 | $199.53 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $1,288.25 | Professional | None | $125.89 | $199.53 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $616.60 Typical High $1,230.27 | Professional | None | $218.78 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $933.25 Typical High $1,819.70 | Professional | 50 · Both sides | $331.13 | $933.25 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $575.44 Typical High $1,071.52 | Facility | None | $275.42 | $575.44 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $741.31 | Professional | None | $186.21 | $309.03 | $741.31 |
DeanCare Setting Facility Modifier None Typical Low $162.18 Median $2,630.27 Typical High $5,128.61 | Facility | None | $162.18 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $691.83 | Professional | None | $295.12 | $436.52 | $691.83 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $912.01 Typical High $1,778.28 | Facility | None | $177.83 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $660.69 Typical High $1,148.15 | Professional | None | $239.88 | $660.69 | $1,148.15 |
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 $316.23 Median $512.86 Typical High $660.69 | Professional | None | $316.23 | $512.86 | $660.69 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $223.87 Typical High $407.38 | Facility | None | $128.82 | $223.87 | $407.38 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $741.31 | Professional | None | $239.88 | $467.74 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $1,288.25 | Facility | None | $269.15 | $407.38 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $416.87 | Professional | None | $186.21 | $295.12 | $416.87 |
Security Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $602.56 | Professional | None | $380.19 | $380.19 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $1,230.27 | Professional | None | $457.09 | $776.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $173.78 Median $446.68 Typical High $912.01 | Professional | None | $173.78 | $446.68 | $912.01 |
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 $63.10 Median $63.10 Typical High $100.00 | Facility | 52 · Reduced service | $63.10 | $63.10 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $39.81 | Facility | 53 · Discontinued | $25.12 | $25.12 | $39.81 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $147.91 | Facility | 54 · Surgery only | $95.50 | $95.50 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $29.51 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $19.95 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $19.95 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $138.04 | Facility | 78 · Unplanned return to OR | $89.13 | $89.13 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $100.00 Typical High $660.69 | Professional | 52 · Reduced service | $63.10 | $100.00 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $39.81 Typical High $263.03 | Professional | 53 · Discontinued | $25.12 | $39.81 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $1,000.00 | Professional | 54 · Surgery only | $95.50 | $147.91 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $199.53 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.95 Typical High $131.83 | Professional | 56 · Pre-op care only | $12.59 | $19.95 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $138.04 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $89.13 | $138.04 | $933.25 |
Where Wisconsin sits
The same service costs 3.5 times more in Wisconsin 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· 1st of 51
$575
WI $575KY $162
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.