How much rates vary
Facilitymedian $1,380 · 10th to 90th $129 to $4,074Professionalmedian $263 · 10th to 90th $95 to $646
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 $60.26 Median $128.82 Typical High $14,454.40 | Facility | None | $60.26 | $128.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $741.31 | Professional | None | $60.26 | $128.82 | $741.31 |
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 $134.90 Median $302.00 Typical High $630.96 | Professional | None | $134.90 | $302.00 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $407.38 Typical High $616.60 | Facility | None | $50.12 | $407.38 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $457.09 | Professional | None | $81.28 | $173.78 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $77.62 Median $2,630.27 Typical High $5,128.61 | Facility | None | $77.62 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $407.38 | Professional | None | $123.03 | $245.47 | $407.38 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $912.01 Typical High $1,778.28 | Facility | None | $141.25 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $501.19 Typical High $1,122.02 | Professional | None | $151.36 | $501.19 | $1,122.02 |
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 $165.96 Median $218.78 Typical High $426.58 | Professional | None | $165.96 | $218.78 | $426.58 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $295.12 | Facility | None | $64.57 | $131.83 | $295.12 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $288.40 Typical High $489.78 | Professional | None | $125.89 | $288.40 | $489.78 |
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 $81.28 Median $151.36 Typical High $239.88 | Professional | None | $81.28 | $151.36 | $239.88 |
Security Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $288.40 | Professional | None | $131.83 | $131.83 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $758.58 | Professional | None | $173.78 | $338.84 | $758.58 |
The Alliance Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $933.25 | Professional | None | $275.42 | $467.74 | $933.25 |
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 $83.18 Median $245.47 Typical High $602.56 | Professional | None | $83.18 | $245.47 | $602.56 |
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 $30.20 Median $30.20 Typical High $64.57 | Facility | 52 · Reduced service | $30.20 | $30.20 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $25.70 | Facility | 53 · Discontinued | $12.02 | $12.02 | $25.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $97.72 | Facility | 54 · Surgery only | $45.71 | $45.71 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $19.50 | Facility | 55 · Aftercare only | $9.12 | $9.12 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $12.88 | Facility | 56 · Pre-op care only | $6.03 | $6.03 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $64.57 Typical High $398.11 | Professional | 52 · Reduced service | $30.20 | $64.57 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.70 Typical High $162.18 | Professional | 53 · Discontinued | $12.02 | $25.70 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $97.72 Typical High $602.56 | Professional | 54 · Surgery only | $45.71 | $97.72 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $19.50 Typical High $120.23 | Professional | 55 · Aftercare only | $9.12 | $19.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $12.88 Typical High $81.28 | Professional | 56 · Pre-op care only | $6.03 | $12.88 | $81.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $61.66 Median $123.03 Typical High $199.53 | Professional | 51 · Multiple procedures | $61.66 | $123.03 | $199.53 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.95 Median $38.90 Typical High $64.57 | Professional | 80 · Assistant surgeon | $19.95 | $38.90 | $64.57 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.95 Median $38.90 Typical High $64.57 | Professional | 81 · Minimal assistant surgeon | $19.95 | $38.90 | $64.57 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.95 Median $38.90 Typical High $64.57 | Professional | 82 · Assistant surgeon, no resident | $19.95 | $38.90 | $64.57 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $17.38 Median $33.88 Typical High $56.23 | Professional | AS · PA/NP assist | $17.38 | $33.88 | $56.23 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$302
AK $355MD $100
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.