How much rates vary
Facilitymedian $1,000 · 10th to 90th $51 to $2,344Professionalmedian $105 · 10th to 90th $39 to $257
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 $23.44 Median $52.48 Typical High $14,454.40 | Facility | None | $23.44 | $52.48 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $52.48 Typical High $977.24 | Professional | None | $23.44 | $52.48 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $257.04 | Professional | None | $54.95 | $114.82 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $186.21 Typical High $302.00 | Facility | None | $50.12 | $186.21 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $69.18 Typical High $181.97 | Professional | None | $31.62 | $69.18 | $181.97 |
DeanCare Setting Facility Modifier None Typical Low $30.20 Median $2,630.27 Typical High $5,128.61 | Facility | None | $30.20 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $162.18 | Professional | None | $48.98 | $97.72 | $162.18 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $812.83 Typical High $1,778.28 | Facility | None | $60.26 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $194.98 Typical High $1,445.44 | Professional | None | $61.66 | $194.98 | $1,445.44 |
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 $66.07 Median $85.11 Typical High $169.82 | Professional | None | $66.07 | $85.11 | $169.82 |
Prevea360 Setting Facility Modifier None Typical Low $23.99 Median $51.29 Typical High $117.49 | Facility | None | $23.99 | $51.29 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $52.48 Median $109.65 Typical High $218.78 | Professional | None | $52.48 | $109.65 | $218.78 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $2,691.53 | Facility | None | $50.12 | $50.12 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $97.72 | Professional | None | $31.62 | $57.54 | $97.72 |
Security Health Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $112.20 | Professional | None | $52.48 | $52.48 | $112.20 |
Security Health Setting Professional Modifier None Typical Low $69.18 Median $141.25 Typical High $302.00 | Professional | None | $69.18 | $141.25 | $302.00 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $33.88 Median $95.50 Typical High $239.88 | Professional | None | $33.88 | $95.50 | $239.88 |
14 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 $11.75 Median $11.75 Typical High $26.30 | Facility | 52 · Reduced service | $11.75 | $11.75 | $26.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $10.47 | Facility | 53 · Discontinued | $4.68 | $4.68 | $10.47 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $17.78 Median $17.78 Typical High $38.90 | Facility | 54 · Surgery only | $17.78 | $17.78 | $38.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $7.76 | Facility | 55 · Aftercare only | $3.55 | $3.55 | $7.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $5.25 | Facility | 56 · Pre-op care only | $2.34 | $2.34 | $5.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $26.30 Typical High $489.78 | Professional | 52 · Reduced service | $11.75 | $26.30 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $10.47 Typical High $194.98 | Professional | 53 · Discontinued | $4.68 | $10.47 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $38.90 Typical High $741.31 | Professional | 54 · Surgery only | $17.78 | $38.90 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $7.76 Typical High $147.91 | Professional | 55 · Aftercare only | $3.55 | $7.76 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $5.25 Typical High $97.72 | Professional | 56 · Pre-op care only | $2.34 | $5.25 | $97.72 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $7.76 Median $15.49 Typical High $25.70 | Professional | 80 · Assistant surgeon | $7.76 | $15.49 | $25.70 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $7.76 Median $15.49 Typical High $25.70 | Professional | 81 · Minimal assistant surgeon | $7.76 | $15.49 | $25.70 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $7.76 Median $15.49 Typical High $25.70 | Professional | 82 · Assistant surgeon, no resident | $7.76 | $15.49 | $25.70 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $6.76 Median $13.80 Typical High $22.91 | Professional | AS · PA/NP assist | $6.76 | $13.80 | $22.91 |
Where Wisconsin sits
The same service costs 4.0 times more in Alaska than in Texas. 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
$115
AK $148TX $37.15
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.