How much rates vary
Facilitymedian $2,754 · 10th to 90th $263 to $5,754Professionalmedian $490 · 10th to 90th $178 to $1,047
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 $120.23 Median $194.98 Typical High $14,454.40 | Facility | None | $120.23 | $194.98 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $1,230.27 | Professional | None | $120.23 | $194.98 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $588.84 Typical High $1,148.15 | Professional | None | $213.80 | $588.84 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $891.25 Typical High $1,737.80 | Professional | 50 · Both sides | $316.23 | $891.25 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $562.34 Typical High $1,071.52 | Facility | None | $275.42 | $562.34 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $724.44 | Professional | None | $177.83 | $295.12 | $724.44 |
DeanCare Setting Facility Modifier None Typical Low $147.91 Median $4,265.80 Typical High $7,762.47 | Facility | None | $147.91 | $4,265.80 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $660.69 | Professional | None | $281.84 | $407.38 | $660.69 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $2,187.76 Typical High $4,786.30 | Facility | None | $245.47 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $630.96 Typical High $1,096.48 | Professional | None | $229.09 | $630.96 | $1,096.48 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $645.65 | Professional | None | $295.12 | $489.78 | $645.65 |
Prevea360 Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $389.05 | Facility | None | $123.03 | $213.80 | $389.05 |
Quartz Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $707.95 | Professional | None | $234.42 | $436.52 | $707.95 |
Quartz Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $1,288.25 | Facility | None | $269.15 | $416.87 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $398.11 | Professional | None | $177.83 | $281.84 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $602.56 | Professional | None | $363.08 | $363.08 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $1,202.26 | Professional | None | $426.58 | $741.31 | $1,202.26 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $165.96 Median $416.87 Typical High $870.96 | Professional | None | $165.96 | $416.87 | $870.96 |
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 $60.26 Median $60.26 Typical High $95.50 | Facility | 52 · Reduced service | $60.26 | $60.26 | $95.50 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $38.90 | Facility | 53 · Discontinued | $23.99 | $23.99 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $144.54 | Facility | 54 · Surgery only | $91.20 | $91.20 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $28.84 | Facility | 55 · Aftercare only | $18.20 | $18.20 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $19.50 | Facility | 56 · Pre-op care only | $12.02 | $12.02 | $19.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $134.90 | Facility | 78 · Unplanned return to OR | $85.11 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $95.50 Typical High $630.96 | Professional | 52 · Reduced service | $60.26 | $95.50 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.90 Typical High $251.19 | Professional | 53 · Discontinued | $23.99 | $38.90 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $144.54 Typical High $954.99 | Professional | 54 · Surgery only | $91.20 | $144.54 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $28.84 Typical High $190.55 | Professional | 55 · Aftercare only | $18.20 | $28.84 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.50 Typical High $125.89 | Professional | 56 · Pre-op care only | $12.02 | $19.50 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $134.90 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $85.11 | $134.90 | $891.25 |
Where Wisconsin sits
The same service costs 3.9 times more in Oklahoma 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
$589
OK $646KY $166
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.