How much rates vary
Facilitymedian $1,380 · 10th to 90th $105 to $3,981Professionalmedian $186 · 10th to 90th $66 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 $41.69 Median $104.71 Typical High $14,454.40 | Facility | None | $41.69 | $104.71 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $104.71 Typical High $562.34 | Professional | None | $41.69 | $104.71 | $562.34 |
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 $95.50 Median $218.78 Typical High $524.81 | Professional | None | $95.50 | $218.78 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $147.91 | Professional | None | $112.20 | $120.23 | $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 $54.95 Median $138.04 Typical High $371.54 | Professional | None | $54.95 | $138.04 | $371.54 |
DeanCare Setting Facility Modifier None Typical Low $57.54 Median $2,630.27 Typical High $5,128.61 | Facility | None | $57.54 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $323.59 | Professional | None | $85.11 | $169.82 | $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 $114.82 Median $389.05 Typical High $912.01 | Professional | None | $114.82 | $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 $120.23 Median $173.78 Typical High $346.74 | Professional | None | $120.23 | $173.78 | $346.74 |
Prevea360 Setting Facility Modifier None Typical Low $44.67 Median $97.72 Typical High $234.42 | Facility | None | $44.67 | $97.72 | $234.42 |
Quartz Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $389.05 | Professional | None | $87.10 | $208.93 | $389.05 |
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 $54.95 Median $120.23 Typical High $194.98 | Professional | None | $54.95 | $120.23 | $194.98 |
Security Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $234.42 | Professional | None | $91.20 | $91.20 | $234.42 |
Security Health Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $602.56 | Professional | None | $120.23 | $251.19 | $602.56 |
The Alliance Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $758.58 | Professional | None | $218.78 | $371.54 | $758.58 |
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 $173.78 Typical High $478.63 | Professional | None | $60.26 | $173.78 | $478.63 |
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 $20.89 Median $20.89 Typical High $51.29 | Facility | 52 · Reduced service | $20.89 | $20.89 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $20.89 | Facility | 53 · Discontinued | $8.32 | $8.32 | $20.89 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $77.62 | Facility | 54 · Surgery only | $30.90 | $30.90 | $77.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $15.49 | Facility | 55 · Aftercare only | $6.17 | $6.17 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $10.47 | Facility | 56 · Pre-op care only | $4.17 | $4.17 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $51.29 Typical High $309.03 | Professional | 52 · Reduced service | $20.89 | $51.29 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $20.89 Typical High $123.03 | Professional | 53 · Discontinued | $8.32 | $20.89 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $77.62 Typical High $467.74 | Professional | 54 · Surgery only | $30.90 | $77.62 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $15.49 Typical High $93.33 | Professional | 55 · Aftercare only | $6.17 | $15.49 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $10.47 Typical High $61.66 | Professional | 56 · Pre-op care only | $4.17 | $10.47 | $61.66 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $42.66 Median $85.11 Typical High $162.18 | Professional | 51 · Multiple procedures | $42.66 | $85.11 | $162.18 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.49 Median $27.54 Typical High $51.29 | Professional | 80 · Assistant surgeon | $13.49 | $27.54 | $51.29 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.49 Median $27.54 Typical High $51.29 | Professional | 81 · Minimal assistant surgeon | $13.49 | $27.54 | $51.29 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.49 Median $27.54 Typical High $51.29 | Professional | 82 · Assistant surgeon, no resident | $13.49 | $27.54 | $51.29 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $23.99 Typical High $45.71 | Professional | AS · PA/NP assist | $11.75 | $23.99 | $45.71 |
Where Wisconsin sits
The same service costs 3.4 times more in Alaska than in New Jersey. 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
$219
AK $251NJ $74.13
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.