How much rates vary
Facilitymedian $1,259 · 10th to 90th $302 to $4,266Professionalmedian $794 · 10th to 90th $295 to $1,549
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 $213.80 Median $316.23 Typical High $14,454.40 | Facility | None | $213.80 | $316.23 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $4,897.79 | Professional | None | $213.80 | $316.23 | $4,897.79 |
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 $371.54 Median $891.25 Typical High $1,513.56 | Professional | None | $371.54 | $891.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $758.58 Typical High $1,513.56 | Facility | None | $371.54 | $758.58 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $1,122.02 | Professional | None | $281.84 | $426.58 | $1,122.02 |
DeanCare Setting Facility Modifier None Typical Low $275.42 Median $2,570.40 Typical High $4,786.30 | Facility | None | $275.42 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $977.24 | Professional | None | $436.52 | $645.65 | $977.24 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $954.99 Typical High $1,778.28 | Facility | None | $229.09 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,000.00 Typical High $2,754.23 | Professional | None | $363.08 | $1,000.00 | $2,754.23 |
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 $478.63 Median $660.69 Typical High $933.25 | Professional | None | $478.63 | $660.69 | $933.25 |
Prevea360 Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $758.58 | Facility | None | $208.93 | $380.19 | $758.58 |
Quartz Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $1,318.26 | Professional | None | $446.68 | $776.25 | $1,318.26 |
Quartz Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,288.25 | Facility | None | $363.08 | $562.34 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $676.08 | Professional | None | $281.84 | $389.05 | $676.08 |
Security Health Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | None | $457.09 | $457.09 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $1,819.70 | Professional | None | $478.63 | $1,096.48 | $1,819.70 |
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 $275.42 Median $707.95 Typical High $1,348.96 | Professional | None | $275.42 | $707.95 | $1,348.96 |
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 $107.15 Median $107.15 Typical High $158.49 | Facility | 52 · Reduced service | $107.15 | $107.15 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $63.10 | Facility | 53 · Discontinued | $42.66 | $42.66 | $63.10 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $239.88 | Facility | 54 · Surgery only | $158.49 | $158.49 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $47.86 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $31.62 | Facility | 56 · Pre-op care only | $21.38 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $158.49 Typical High $2,454.71 | Professional | 52 · Reduced service | $107.15 | $158.49 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $63.10 Typical High $1,000.00 | Professional | 53 · Discontinued | $42.66 | $63.10 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $239.88 Typical High $3,715.35 | Professional | 54 · Surgery only | $158.49 | $239.88 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $47.86 Typical High $741.31 | Professional | 55 · Aftercare only | $31.62 | $47.86 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $31.62 Typical High $489.78 | Professional | 56 · Pre-op care only | $21.38 | $31.62 | $489.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $323.59 Typical High $489.78 | Professional | 51 · Multiple procedures | $218.78 | $323.59 | $489.78 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $104.71 Typical High $158.49 | Professional | 80 · Assistant surgeon | $69.18 | $104.71 | $158.49 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $104.71 Typical High $158.49 | Professional | 81 · Minimal assistant surgeon | $69.18 | $104.71 | $158.49 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $104.71 Typical High $158.49 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $104.71 | $158.49 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $91.20 Typical High $138.04 | Professional | AS · PA/NP assist | $61.66 | $91.20 | $138.04 |
Where Wisconsin sits
The same service costs 4.0 times more in Alaska than in New York. 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
$871
AK $1,023NY $257
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.