How much rates vary
Facilitymedian $1,202 · 10th to 90th $98 to $3,802Professionalmedian $174 · 10th to 90th $60 to $479
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 $38.02 Median $97.72 Typical High $14,454.40 | Facility | None | $38.02 | $97.72 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $97.72 Typical High $524.81 | Professional | None | $38.02 | $97.72 | $524.81 |
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 $87.10 Median $204.17 Typical High $467.74 | Professional | None | $87.10 | $204.17 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $138.04 | Professional | None | $104.71 | $112.20 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $208.93 Typical High $363.08 | Facility | None | $50.12 | $208.93 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $128.82 Typical High $346.74 | Professional | None | $51.29 | $128.82 | $346.74 |
DeanCare Setting Facility Modifier None Typical Low $48.98 Median $2,630.27 Typical High $5,128.61 | Facility | None | $48.98 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $309.03 | Professional | None | $77.62 | $154.88 | $309.03 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $912.01 Typical High $1,778.28 | Facility | None | $125.89 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $371.54 Typical High $851.14 | Professional | None | $104.71 | $371.54 | $851.14 |
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 $95.50 Median $165.96 Typical High $323.59 | Professional | None | $95.50 | $165.96 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $39.81 Median $91.20 Typical High $218.78 | Facility | None | $39.81 | $91.20 | $218.78 |
Quartz Setting Professional Modifier None Typical Low $77.62 Median $194.98 Typical High $371.54 | Professional | None | $77.62 | $194.98 | $371.54 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $151.36 Typical High $229.09 | Facility | None | $50.12 | $151.36 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $51.29 Median $112.20 Typical High $181.97 | Professional | None | $51.29 | $112.20 | $181.97 |
Security Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $223.87 | Professional | None | $83.18 | $83.18 | $223.87 |
Security Health Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $575.44 | Professional | None | $109.65 | $229.09 | $575.44 |
The Alliance Setting Professional Modifier None Typical Low $75.86 Median $208.93 Typical High $588.84 | Professional | None | $75.86 | $208.93 | $588.84 |
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 $53.70 Median $162.18 Typical High $446.68 | Professional | None | $53.70 | $162.18 | $446.68 |
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 $19.05 Median $19.05 Typical High $48.98 | Facility | 52 · Reduced service | $19.05 | $19.05 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $19.50 | Facility | 53 · Discontinued | $7.76 | $7.76 | $19.50 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $72.44 | Facility | 54 · Surgery only | $28.84 | $28.84 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $14.79 | Facility | 55 · Aftercare only | $5.75 | $5.75 | $14.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $9.77 | Facility | 56 · Pre-op care only | $3.80 | $3.80 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $48.98 Typical High $275.42 | Professional | 52 · Reduced service | $19.05 | $48.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $19.50 Typical High $109.65 | Professional | 53 · Discontinued | $7.76 | $19.50 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $72.44 Typical High $416.87 | Professional | 54 · Surgery only | $28.84 | $72.44 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $14.79 Typical High $83.18 | Professional | 55 · Aftercare only | $5.75 | $14.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $9.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $3.80 | $9.77 | $54.95 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $38.90 Median $77.62 Typical High $151.36 | Professional | 51 · Multiple procedures | $38.90 | $77.62 | $151.36 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.59 Median $25.12 Typical High $48.98 | Professional | 80 · Assistant surgeon | $12.59 | $25.12 | $48.98 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $12.59 Median $25.12 Typical High $48.98 | Professional | 81 · Minimal assistant surgeon | $12.59 | $25.12 | $48.98 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $12.59 Median $25.12 Typical High $48.98 | Professional | 82 · Assistant surgeon, no resident | $12.59 | $25.12 | $48.98 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $21.88 Typical High $42.66 | Professional | AS · PA/NP assist | $10.96 | $21.88 | $42.66 |
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
$204
AK $229KY $66.07
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.