How much rates vary
Facilitymedian $1,259 · 10th to 90th $282 to $7,079Professionalmedian $1,778 · 10th to 90th $708 to $5,370
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 $691.83 Median $1,905.46 Typical High $14,454.40 | Facility | None | $691.83 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $8,709.64 | Professional | None | $691.83 | $691.83 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $8,128.31 | Facility | None | $7,079.46 | $7,079.46 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $2,691.53 Typical High $5,370.32 | Professional | None | $707.95 | $2,691.53 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $426.58 Typical High $851.14 | Professional | 80 · Assistant surgeon | $112.20 | $426.58 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $371.54 Typical High $758.58 | Professional | AS · PA/NP assist | $97.72 | $371.54 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $2,691.53 | Facility | None | $812.83 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,258.93 | $3,388.44 |
DeanCare Setting Facility Modifier None Typical Low $776.25 Median $7,943.28 Typical High $14,454.40 | Facility | None | $776.25 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,513.56 | $2,187.76 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $346.74 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $302.00 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $302.00 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,122.02 Typical High $2,041.74 | Facility | None | $234.42 | $1,122.02 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,995.26 Typical High $8,511.38 | Professional | None | $831.76 | $1,995.26 | $8,511.38 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,344.23 | Facility | None | $831.76 | $1,047.13 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $870.96 Median $1,778.28 Typical High $2,137.96 | Professional | None | $870.96 | $1,778.28 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $1,584.89 | Facility | None | $645.65 | $812.83 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $1,584.89 Typical High $3,235.94 | Professional | None | $741.31 | $1,584.89 | $3,235.94 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,691.53 | Facility | None | $758.58 | $1,023.29 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,258.93 | $1,258.93 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $1,479.11 Median $4,466.84 Typical High $5,495.41 | Professional | None | $1,479.11 | $4,466.84 | $5,495.41 |
The Alliance Setting Professional Modifier None Typical Low $1,445.44 Median $3,162.28 Typical High $4,897.79 | Professional | None | $1,445.44 | $3,162.28 | $4,897.79 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,230.27 Typical High $1,862.09 | Facility | None | $218.78 | $1,230.27 | $1,862.09 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,513.56 Typical High $3,548.13 | Professional | None | $776.25 | $1,513.56 | $3,548.13 |
8 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 Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $4,466.84 | Professional | 52 · Reduced service | $346.74 | $346.74 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $1,778.28 | Professional | 53 · Discontinued | $138.04 | $138.04 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $6,606.93 | Professional | 54 · Surgery only | $512.86 | $512.86 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $1,318.26 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $891.25 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $891.25 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $954.99 Typical High $1,348.96 | Professional | 62 · Two surgeons | $776.25 | $954.99 | $1,348.96 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $194.98 | $239.88 | $346.74 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $239.88 | $346.74 |
Where Wisconsin sits
The same service costs 15.4 times more in Alabama 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.
Physician feeFacility fee
AL $15,703MD $1,022
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.