How much rates vary
Facilitymedian $1,380 · 10th to 90th $85 to $3,981Professionalmedian $138 · 10th to 90th $45 to $417
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 $28.84 Median $85.11 Typical High $14,454.40 | Facility | None | $28.84 | $85.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $85.11 Typical High $588.84 | Professional | None | $28.84 | $85.11 | $588.84 |
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 $77.62 Median $151.36 Typical High $416.87 | Professional | None | $77.62 | $151.36 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $120.23 | Professional | None | $91.20 | $97.72 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $269.15 Typical High $407.38 | Facility | None | $50.12 | $269.15 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $100.00 Typical High $302.00 | Professional | None | $38.02 | $100.00 | $302.00 |
DeanCare Setting Facility Modifier None Typical Low $37.15 Median $2,630.27 Typical High $5,128.61 | Facility | None | $37.15 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $263.03 | Professional | None | $58.88 | $114.82 | $263.03 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $912.01 Typical High $1,778.28 | Facility | None | $109.65 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $316.23 Typical High $741.31 | Professional | None | $87.10 | $316.23 | $741.31 |
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 $67.61 Median $144.54 Typical High $275.42 | Professional | None | $67.61 | $144.54 | $275.42 |
Prevea360 Setting Facility Modifier None Typical Low $30.90 Median $67.61 Typical High $186.21 | Facility | None | $30.90 | $67.61 | $186.21 |
Quartz Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $316.23 | Professional | None | $60.26 | $144.54 | $316.23 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $38.02 Median $91.20 Typical High $158.49 | Professional | None | $38.02 | $91.20 | $158.49 |
Security Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $194.98 | Professional | None | $63.10 | $63.10 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $501.19 | Professional | None | $81.28 | $177.83 | $501.19 |
The Alliance Setting Professional Modifier None Typical Low $57.54 Median $194.98 Typical High $501.19 | Professional | None | $57.54 | $194.98 | $501.19 |
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 $39.81 Median $125.89 Typical High $380.19 | Professional | None | $39.81 | $125.89 | $380.19 |
15 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 $14.45 Median $14.45 Typical High $42.66 | Facility | 52 · Reduced service | $14.45 | $14.45 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $16.98 | Facility | 53 · Discontinued | $5.75 | $5.75 | $16.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $63.10 | Facility | 54 · Surgery only | $21.38 | $21.38 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $12.59 | Facility | 55 · Aftercare only | $4.27 | $4.27 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $8.51 | Facility | 56 · Pre-op care only | $2.88 | $2.88 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $42.66 Typical High $295.12 | Professional | 52 · Reduced service | $14.45 | $42.66 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $16.98 Typical High $117.49 | Professional | 53 · Discontinued | $5.75 | $16.98 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $63.10 Typical High $446.68 | Professional | 54 · Surgery only | $21.38 | $63.10 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $12.59 Typical High $89.13 | Professional | 55 · Aftercare only | $4.27 | $12.59 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $8.51 Typical High $58.88 | Professional | 56 · Pre-op care only | $2.88 | $8.51 | $58.88 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $29.51 Median $57.54 Typical High $131.83 | Professional | 51 · Multiple procedures | $29.51 | $57.54 | $131.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.55 Median $18.62 Typical High $42.66 | Professional | 80 · Assistant surgeon | $9.55 | $18.62 | $42.66 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.55 Median $18.62 Typical High $42.66 | Professional | 81 · Minimal assistant surgeon | $9.55 | $18.62 | $42.66 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.55 Median $18.62 Typical High $42.66 | Professional | 82 · Assistant surgeon, no resident | $9.55 | $18.62 | $42.66 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $8.32 Median $16.22 Typical High $37.15 | Professional | AS · PA/NP assist | $8.32 | $16.22 | $37.15 |
Where Wisconsin sits
The same service costs 3.3 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
$166
AK $170KY $51.29
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.