How much rates vary
Facilitymedian $1,202 · 10th to 90th $155 to $3,802Professionalmedian $339 · 10th to 90th $129 to $776
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 $81.28 Median $154.88 Typical High $14,454.40 | Facility | None | $81.28 | $154.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $851.14 | Professional | None | $81.28 | $154.88 | $851.14 |
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 $177.83 Median $389.05 Typical High $776.25 | Professional | None | $177.83 | $389.05 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $295.12 Typical High $645.65 | Facility | None | $50.12 | $295.12 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $549.54 | Professional | None | $107.15 | $204.17 | $549.54 |
DeanCare Setting Facility Modifier None Typical Low $104.71 Median $2,630.27 Typical High $5,128.61 | Facility | None | $104.71 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $478.63 | Professional | None | $165.96 | $316.23 | $478.63 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $912.01 Typical High $1,778.28 | Facility | None | $151.36 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $588.84 Typical High $1,348.96 | Professional | None | $181.97 | $588.84 | $1,348.96 |
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 $213.80 Median $281.84 Typical High $512.86 | Professional | None | $213.80 | $281.84 | $512.86 |
Prevea360 Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $363.08 | Facility | None | $79.43 | $154.88 | $363.08 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $588.84 | Professional | None | $165.96 | $346.74 | $588.84 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $213.80 Typical High $346.74 | Facility | None | $50.12 | $213.80 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $288.40 | Professional | None | $107.15 | $177.83 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $346.74 | Professional | None | $177.83 | $177.83 | $346.74 |
Security Health Setting Professional Modifier None Typical Low $234.42 Median $457.09 Typical High $891.25 | Professional | None | $234.42 | $457.09 | $891.25 |
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 $114.82 Median $309.03 Typical High $724.44 | Professional | None | $114.82 | $309.03 | $724.44 |
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 $40.74 Median $40.74 Typical High $77.62 | Facility | 52 · Reduced service | $40.74 | $40.74 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $30.90 | Facility | 53 · Discontinued | $16.22 | $16.22 | $30.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $114.82 | Facility | 54 · Surgery only | $60.26 | $60.26 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $22.91 | Facility | 55 · Aftercare only | $12.30 | $12.30 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $15.49 | Facility | 56 · Pre-op care only | $8.13 | $8.13 | $15.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $77.62 Typical High $467.74 | Professional | 52 · Reduced service | $40.74 | $77.62 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $30.90 Typical High $186.21 | Professional | 53 · Discontinued | $16.22 | $30.90 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $114.82 Typical High $707.95 | Professional | 54 · Surgery only | $60.26 | $114.82 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $22.91 Typical High $141.25 | Professional | 55 · Aftercare only | $12.30 | $22.91 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $15.49 Typical High $93.33 | Professional | 56 · Pre-op care only | $8.13 | $15.49 | $93.33 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $158.49 Typical High $239.88 | Professional | 51 · Multiple procedures | $83.18 | $158.49 | $239.88 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $50.12 Typical High $77.62 | Professional | 80 · Assistant surgeon | $26.30 | $50.12 | $77.62 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $50.12 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $26.30 | $50.12 | $77.62 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $50.12 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $50.12 | $77.62 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $44.67 Typical High $67.61 | Professional | AS · PA/NP assist | $23.44 | $44.67 | $67.61 |
Where Wisconsin sits
The same service costs 3.3 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
$372
AK $398MD $120
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.