How much rates vary
Facilitymedian $1,585 · 10th to 90th $145 to $4,266Professionalmedian $302 · 10th to 90th $120 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 $75.86 Median $120.23 Typical High $14,454.40 | Facility | None | $75.86 | $120.23 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $1,000.00 | Professional | None | $75.86 | $120.23 | $1,000.00 |
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 $144.54 Median $354.81 Typical High $645.65 | Professional | None | $144.54 | $354.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $380.19 Typical High $758.58 | Facility | None | $131.83 | $380.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $467.74 | Professional | None | $102.33 | $177.83 | $467.74 |
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 $154.88 Median $251.19 Typical High $380.19 | Professional | None | $154.88 | $251.19 | $380.19 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $1,412.54 Typical High $3,019.95 | Facility | None | $165.96 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $457.09 Typical High $1,071.52 | Professional | None | $154.88 | $457.09 | $1,071.52 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $398.11 | Professional | None | $199.53 | $275.42 | $398.11 |
Prevea360 Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $281.84 | Facility | None | $81.28 | $138.04 | $281.84 |
Quartz Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $489.78 | Professional | None | $162.18 | $288.40 | $489.78 |
Quartz Setting Facility Modifier None Typical Low $128.82 Median $199.53 Typical High $1,071.52 | Facility | None | $128.82 | $199.53 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $257.04 | Professional | None | $102.33 | $151.36 | $257.04 |
Security Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $269.15 | Professional | None | $169.82 | $169.82 | $269.15 |
Security Health Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $691.83 | Professional | None | $204.17 | $436.52 | $691.83 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $109.65 Median $275.42 Typical High $562.34 | Professional | None | $109.65 | $275.42 | $562.34 |
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 $38.02 Median $38.02 Typical High $60.26 | Facility | 52 · Reduced service | $38.02 | $38.02 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $24.55 | Facility | 53 · Discontinued | $15.14 | $15.14 | $24.55 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $91.20 | Facility | 54 · Surgery only | $57.54 | $57.54 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $18.20 | Facility | 55 · Aftercare only | $11.48 | $11.48 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $12.02 | Facility | 56 · Pre-op care only | $7.59 | $7.59 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $60.26 Typical High $549.54 | Professional | 52 · Reduced service | $38.02 | $60.26 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $24.55 Typical High $218.78 | Professional | 53 · Discontinued | $15.14 | $24.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $91.20 Typical High $812.83 | Professional | 54 · Surgery only | $57.54 | $91.20 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $162.18 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.02 Typical High $109.65 | Professional | 56 · Pre-op care only | $7.59 | $12.02 | $109.65 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 51 · Multiple procedures | $77.62 | $125.89 | $190.55 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $25.12 Median $39.81 Typical High $60.26 | Professional | 80 · Assistant surgeon | $25.12 | $39.81 | $60.26 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $25.12 Median $39.81 Typical High $60.26 | Professional | 81 · Minimal assistant surgeon | $25.12 | $39.81 | $60.26 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $25.12 Median $39.81 Typical High $60.26 | Professional | 82 · Assistant surgeon, no resident | $25.12 | $39.81 | $60.26 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $21.88 Median $34.67 Typical High $52.48 | Professional | AS · PA/NP assist | $21.88 | $34.67 | $52.48 |
Where Wisconsin sits
The same service costs 3.2 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 $372FL $117
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.