How much rates vary
Facilitymedian $1,259 · 10th to 90th $132 to $2,818Professionalmedian $288 · 10th to 90th $87 to $871
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 $64.57 Median $186.21 Typical High $14,454.40 | Facility | None | $64.57 | $186.21 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $186.21 Typical High $1,445.44 | Professional | None | $64.57 | $186.21 | $1,445.44 |
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 $97.72 Median $251.19 Typical High $549.54 | Professional | None | $97.72 | $251.19 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $380.19 Typical High $812.83 | Professional | 50 · Both sides | $144.54 | $380.19 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $575.44 Typical High $851.14 | Facility | None | $501.19 | $575.44 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $302.00 Typical High $776.25 | Professional | None | $117.49 | $302.00 | $776.25 |
DeanCare Setting Facility Modifier None Typical Low $107.15 Median $2,754.23 Typical High $5,128.61 | Facility | None | $107.15 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $524.81 | Professional | None | $120.23 | $223.87 | $524.81 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $338.84 Typical High $776.25 | Professional | 50 · Both sides | $181.97 | $338.84 | $776.25 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $1,318.26 Typical High $2,041.74 | Facility | None | $138.04 | $1,318.26 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $794.33 Typical High $2,691.53 | Professional | None | $234.42 | $794.33 | $2,691.53 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,344.23 | Facility | None | $831.76 | $1,819.70 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $501.19 | Professional | None | $162.18 | $295.12 | $501.19 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $316.23 | Facility | None | $72.44 | $138.04 | $316.23 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $281.84 Typical High $645.65 | Professional | None | $97.72 | $281.84 | $645.65 |
Quartz Setting Professional Modifier None Typical Low $117.49 Median $295.12 Typical High $389.05 | Professional | None | $117.49 | $295.12 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $645.65 | Professional | None | $218.78 | $218.78 | $645.65 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $512.86 Typical High $1,318.26 | Professional | None | $229.09 | $512.86 | $1,318.26 |
The Alliance Setting Professional Modifier None Typical Low $117.49 Median $380.19 Typical High $933.25 | Professional | None | $117.49 | $380.19 | $933.25 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $97.72 Median $295.12 Typical High $812.83 | Professional | None | $97.72 | $295.12 | $812.83 |
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 $32.36 Median $32.36 Typical High $91.20 | Facility | 52 · Reduced service | $32.36 | $32.36 | $91.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $37.15 | Facility | 53 · Discontinued | $12.88 | $12.88 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $138.04 | Facility | 54 · Surgery only | $47.86 | $47.86 | $138.04 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $27.54 | Facility | 55 · Aftercare only | $9.55 | $9.55 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $18.62 | Facility | 56 · Pre-op care only | $6.46 | $6.46 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $91.20 Typical High $741.31 | Professional | 52 · Reduced service | $32.36 | $91.20 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $37.15 Typical High $302.00 | Professional | 53 · Discontinued | $12.88 | $37.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $138.04 Typical High $1,122.02 | Professional | 54 · Surgery only | $47.86 | $138.04 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $27.54 Typical High $223.87 | Professional | 55 · Aftercare only | $9.55 | $27.54 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $18.62 Typical High $151.36 | Professional | 56 · Pre-op care only | $6.46 | $18.62 | $151.36 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $112.20 Typical High $257.04 | Professional | 51 · Multiple procedures | $60.26 | $112.20 | $257.04 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $35.48 Typical High $83.18 | Professional | 80 · Assistant surgeon | $19.05 | $35.48 | $83.18 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $35.48 Typical High $83.18 | Professional | 81 · Minimal assistant surgeon | $19.05 | $35.48 | $83.18 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $35.48 Typical High $83.18 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $35.48 | $83.18 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $31.62 Typical High $72.44 | Professional | AS · PA/NP assist | $16.98 | $31.62 | $72.44 |
Where Wisconsin sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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
$302
NC $302IN $85.11
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.