How much rates vary
Facilitymedian $1,202 · 10th to 90th $135 to $3,802Professionalmedian $316 · 10th to 90th $123 to $617
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 $85.11 Median $123.03 Typical High $14,454.40 | Facility | None | $85.11 | $123.03 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $2,344.23 | Professional | None | $85.11 | $123.03 | $2,344.23 |
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 $147.91 Median $380.19 Typical High $616.60 | Professional | None | $147.91 | $380.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $229.09 Typical High $446.68 | Facility | None | $50.12 | $229.09 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $426.58 | Professional | None | $112.20 | $177.83 | $426.58 |
DeanCare Setting Facility Modifier None Typical Low $117.49 Median $2,630.27 Typical High $5,128.61 | Facility | None | $117.49 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $389.05 | Professional | None | $173.78 | $251.19 | $389.05 |
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 $154.88 Median $416.87 Typical High $1,071.52 | Professional | None | $154.88 | $416.87 | $1,071.52 |
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 $194.98 Median $302.00 Typical High $398.11 | Professional | None | $194.98 | $302.00 | $398.11 |
Prevea360 Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $263.03 | Facility | None | $91.20 | $151.36 | $263.03 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $512.86 | Professional | None | $173.78 | $309.03 | $512.86 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $165.96 Typical High $251.19 | Facility | None | $50.12 | $165.96 | $251.19 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $263.03 | Professional | None | $112.20 | $162.18 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $263.03 | Professional | None | $186.21 | $186.21 | $263.03 |
Security Health Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $707.95 | Professional | None | $213.80 | $478.63 | $707.95 |
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 $117.49 Median $288.40 Typical High $512.86 | Professional | None | $117.49 | $288.40 | $512.86 |
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 $42.66 Median $42.66 Typical High $61.66 | Facility | 52 · Reduced service | $42.66 | $42.66 | $61.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $24.55 | Facility | 53 · Discontinued | $16.98 | $16.98 | $24.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | 54 · Surgery only | $63.10 | $63.10 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $18.62 | Facility | 55 · Aftercare only | $12.59 | $12.59 | $18.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $12.30 | Facility | 56 · Pre-op care only | $8.51 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $61.66 Typical High $1,148.15 | Professional | 52 · Reduced service | $42.66 | $61.66 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $24.55 Typical High $467.74 | Professional | 53 · Discontinued | $16.98 | $24.55 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $93.33 Typical High $1,737.80 | Professional | 54 · Surgery only | $63.10 | $93.33 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.62 Typical High $346.74 | Professional | 55 · Aftercare only | $12.59 | $18.62 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.30 Typical High $234.42 | Professional | 56 · Pre-op care only | $8.51 | $12.30 | $234.42 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $125.89 Typical High $190.55 | Professional | 51 · Multiple procedures | $87.10 | $125.89 | $190.55 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $40.74 Typical High $61.66 | Professional | 80 · Assistant surgeon | $27.54 | $40.74 | $61.66 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $27.54 Median $40.74 Typical High $61.66 | Professional | 81 · Minimal assistant surgeon | $27.54 | $40.74 | $61.66 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $27.54 Median $40.74 Typical High $61.66 | Professional | 82 · Assistant surgeon, no resident | $27.54 | $40.74 | $61.66 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $35.48 Typical High $53.70 | Professional | AS · PA/NP assist | $24.55 | $35.48 | $53.70 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$355
AK $407FL $110
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.