How much rates vary
Facilitymedian $1,202 · 10th to 90th $126 to $3,802Professionalmedian $224 · 10th to 90th $83 to $550
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 $53.70 Median $114.82 Typical High $14,454.40 | Facility | None | $53.70 | $114.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $660.69 | Professional | None | $53.70 | $114.82 | $660.69 |
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 $120.23 Median $269.15 Typical High $549.54 | Professional | None | $120.23 | $269.15 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $165.96 | Professional | None | $125.89 | $134.90 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $234.42 Typical High $426.58 | Facility | None | $50.12 | $234.42 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $154.88 Typical High $416.87 | Professional | None | $70.79 | $154.88 | $416.87 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $2,630.27 Typical High $5,128.61 | Facility | None | $69.18 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $109.65 Median $213.80 Typical High $363.08 | Professional | None | $109.65 | $213.80 | $363.08 |
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 $128.82 Median $371.54 Typical High $1,023.29 | Professional | None | $128.82 | $371.54 | $1,023.29 |
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 $141.25 Median $194.98 Typical High $316.23 | Professional | None | $141.25 | $194.98 | $316.23 |
Prevea360 Setting Facility Modifier None Typical Low $56.23 Median $117.49 Typical High $263.03 | Facility | None | $56.23 | $117.49 | $263.03 |
Quartz Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $436.52 | Professional | None | $109.65 | $257.04 | $436.52 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $169.82 Typical High $257.04 | Facility | None | $50.12 | $169.82 | $257.04 |
Quartz Setting Professional Modifier None Typical Low $70.79 Median $131.83 Typical High $213.80 | Professional | None | $70.79 | $131.83 | $213.80 |
Security Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $263.03 | Professional | None | $114.82 | $114.82 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $676.08 | Professional | None | $151.36 | $302.00 | $676.08 |
The Alliance Setting Professional Modifier None Typical Low $93.33 Median $316.23 Typical High $602.56 | Professional | None | $93.33 | $316.23 | $602.56 |
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 $74.13 Median $208.93 Typical High $501.19 | Professional | None | $74.13 | $208.93 | $501.19 |
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 $26.30 Median $26.30 Typical High $57.54 | Facility | 52 · Reduced service | $26.30 | $26.30 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $23.44 | Facility | 53 · Discontinued | $10.72 | $10.72 | $23.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $87.10 | Facility | 54 · Surgery only | $39.81 | $39.81 | $87.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $17.38 | Facility | 55 · Aftercare only | $7.94 | $7.94 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $11.48 | Facility | 56 · Pre-op care only | $5.37 | $5.37 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $57.54 Typical High $331.13 | Professional | 52 · Reduced service | $26.30 | $57.54 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $23.44 Typical High $134.90 | Professional | 53 · Discontinued | $10.72 | $23.44 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $87.10 Typical High $501.19 | Professional | 54 · Surgery only | $39.81 | $87.10 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $17.38 Typical High $100.00 | Professional | 55 · Aftercare only | $7.94 | $17.38 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $11.48 Typical High $66.07 | Professional | 56 · Pre-op care only | $5.37 | $11.48 | $66.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $54.95 Median $107.15 Typical High $181.97 | Professional | 51 · Multiple procedures | $54.95 | $107.15 | $181.97 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $17.38 Median $34.67 Typical High $57.54 | Professional | 80 · Assistant surgeon | $17.38 | $34.67 | $57.54 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $17.38 Median $34.67 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $17.38 | $34.67 | $57.54 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $17.38 Median $34.67 Typical High $57.54 | Professional | 82 · Assistant surgeon, no resident | $17.38 | $34.67 | $57.54 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $15.14 Median $30.20 Typical High $50.12 | Professional | AS · PA/NP assist | $15.14 | $30.20 | $50.12 |
Where Wisconsin sits
The same service costs 3.2 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
$263
AK $275KY $85.11
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.