How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,454Professionalmedian $2,818 · 10th to 90th $891 to $5,370
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 $851.14 Median $11,220.18 Typical High $14,454.40 | Facility | None | $851.14 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $8,912.51 | Professional | None | $851.14 | $851.14 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $5,754.40 | Professional | None | $1,148.15 | $3,162.28 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $4,677.35 Typical High $8,511.38 | Professional | 50 · Both sides | $1,737.80 | $4,677.35 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $7,585.78 | Facility | None | $1,862.09 | $3,981.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,949.84 | $3,311.31 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,000.00 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,621.81 | $2,398.83 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,023.29 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $5,888.44 | Professional | None | $1,047.13 | $2,754.23 | $5,888.44 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,951.21 | Professional | None | $1,348.96 | $2,290.87 | $2,951.21 |
Prevea360 Setting Facility Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,778.28 | Facility | None | $870.96 | $1,000.00 | $1,778.28 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,981.07 | Professional | None | $912.01 | $2,089.30 | $3,981.07 |
Quartz Setting Facility Modifier None Typical Low $1,479.11 Median $5,248.07 Typical High $8,317.64 | Facility | None | $1,479.11 | $5,248.07 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,230.27 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,981.07 Typical High $5,248.07 | Professional | None | $2,884.03 | $3,981.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $831.76 Median $2,398.83 Typical High $4,897.79 | Professional | None | $831.76 | $2,398.83 | $4,897.79 |
6 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 Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $4,466.84 | Professional | 52 · Reduced service | $416.87 | $416.87 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $1,778.28 | Professional | 53 · Discontinued | $169.82 | $169.82 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $6,760.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $1,348.96 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $891.25 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $6,309.57 |
Where Wisconsin sits
The same service costs 7.2 times more in Alaska than in Texas. 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
$3,467
AK $3,715TX $513
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.