How much rates vary
Facilitymedian $1,380 · 10th to 90th $102 to $3,981Professionalmedian $195 · 10th to 90th $69 to $501
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 $43.65 Median $102.33 Typical High $14,454.40 | Facility | None | $43.65 | $102.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $102.33 Typical High $630.96 | Professional | None | $43.65 | $102.33 | $630.96 |
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 $97.72 Median $229.09 Typical High $512.86 | Professional | None | $97.72 | $229.09 | $512.86 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $147.91 | Professional | None | $109.65 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $323.59 Typical High $501.19 | Facility | None | $50.12 | $323.59 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $138.04 Typical High $363.08 | Professional | None | $57.54 | $138.04 | $363.08 |
DeanCare Setting Facility Modifier None Typical Low $56.23 Median $2,630.27 Typical High $5,128.61 | Facility | None | $56.23 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $323.59 | Professional | None | $89.13 | $173.78 | $323.59 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $912.01 Typical High $1,778.28 | Facility | None | $128.82 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $389.05 Typical High $912.01 | Professional | None | $112.20 | $389.05 | $912.01 |
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 $114.82 Median $173.78 Typical High $338.84 | Professional | None | $114.82 | $173.78 | $338.84 |
Prevea360 Setting Facility Modifier None Typical Low $43.65 Median $102.33 Typical High $229.09 | Facility | None | $43.65 | $102.33 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $380.19 | Professional | None | $89.13 | $218.78 | $380.19 |
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 $57.54 Median $117.49 Typical High $190.55 | Professional | None | $57.54 | $117.49 | $190.55 |
Security Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $234.42 | Professional | None | $95.50 | $95.50 | $234.42 |
Security Health Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $602.56 | Professional | None | $125.89 | $257.04 | $602.56 |
The Alliance Setting Professional Modifier None Typical Low $87.10 Median $275.42 Typical High $616.60 | Professional | None | $87.10 | $275.42 | $616.60 |
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 $60.26 Median $177.83 Typical High $467.74 | Professional | None | $60.26 | $177.83 | $467.74 |
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 $21.88 Median $21.88 Typical High $51.29 | Facility | 52 · Reduced service | $21.88 | $21.88 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $20.42 | Facility | 53 · Discontinued | $8.71 | $8.71 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $32.36 Median $32.36 Typical High $77.62 | Facility | 54 · Surgery only | $32.36 | $32.36 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $15.49 | Facility | 55 · Aftercare only | $6.61 | $6.61 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $10.23 | Facility | 56 · Pre-op care only | $4.37 | $4.37 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $51.29 Typical High $331.13 | Professional | 52 · Reduced service | $21.88 | $51.29 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $20.42 Typical High $131.83 | Professional | 53 · Discontinued | $8.71 | $20.42 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $77.62 Typical High $489.78 | Professional | 54 · Surgery only | $32.36 | $77.62 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $15.49 Typical High $97.72 | Professional | 55 · Aftercare only | $6.61 | $15.49 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $10.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $4.37 | $10.23 | $66.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $44.67 Median $87.10 Typical High $162.18 | Professional | 51 · Multiple procedures | $44.67 | $87.10 | $162.18 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.45 Median $28.18 Typical High $51.29 | Professional | 80 · Assistant surgeon | $14.45 | $28.18 | $51.29 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $14.45 Median $28.18 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $14.45 | $28.18 | $51.29 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $14.45 Median $28.18 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $14.45 | $28.18 | $51.29 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $12.59 Median $24.55 Typical High $44.67 | Professional | AS · PA/NP assist | $12.59 | $24.55 | $44.67 |
Where Wisconsin sits
The same service costs 3.5 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
$224
AK $257KY $72.44
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.