How much rates vary
Facilitymedian $1,202 · 10th to 90th $219 to $3,802Professionalmedian $550 · 10th to 90th $234 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 $173.78 Median $302.00 Typical High $14,454.40 | Facility | None | $173.78 | $302.00 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $2,454.71 | Professional | None | $173.78 | $302.00 | $2,454.71 |
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 $239.88 Median $645.65 Typical High $1,318.26 | Professional | None | $239.88 | $645.65 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $389.05 Typical High $954.99 | Facility | None | $50.12 | $389.05 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $1,230.27 | Professional | None | $316.23 | $549.54 | $1,230.27 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $2,630.27 Typical High $5,128.61 | Facility | None | $208.93 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $812.83 | Professional | None | $331.13 | $537.03 | $812.83 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,122.02 Typical High $2,238.72 | Professional | None | $295.12 | $1,122.02 | $2,238.72 |
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 $380.19 Median $562.34 Typical High $776.25 | Professional | None | $380.19 | $562.34 | $776.25 |
Prevea360 Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $562.34 | Facility | None | $173.78 | $288.40 | $562.34 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $724.44 Typical High $1,202.26 | Professional | None | $371.54 | $724.44 | $1,202.26 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $281.84 Typical High $426.58 | Facility | None | $50.12 | $281.84 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $660.69 | Professional | None | $316.23 | $489.78 | $660.69 |
Security Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $933.25 | Professional | None | $562.34 | $562.34 | $933.25 |
Security Health Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,949.84 | Professional | None | $691.83 | $1,122.02 | $1,949.84 |
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 $204.17 Median $426.58 Typical High $1,202.26 | Professional | None | $204.17 | $426.58 | $1,202.26 |
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 $87.10 Median $87.10 Typical High $151.36 | Facility | 52 · Reduced service | $87.10 | $87.10 | $151.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $60.26 | Facility | 53 · Discontinued | $35.48 | $35.48 | $60.26 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $223.87 | Facility | 54 · Surgery only | $131.83 | $131.83 | $223.87 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $45.71 | Facility | 55 · Aftercare only | $26.30 | $26.30 | $45.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $30.20 | Facility | 56 · Pre-op care only | $17.38 | $17.38 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $151.36 Typical High $1,230.27 | Professional | 52 · Reduced service | $87.10 | $151.36 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $60.26 Typical High $489.78 | Professional | 53 · Discontinued | $35.48 | $60.26 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $223.87 Typical High $1,819.70 | Professional | 54 · Surgery only | $131.83 | $223.87 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $45.71 Typical High $363.08 | Professional | 55 · Aftercare only | $26.30 | $45.71 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $30.20 Typical High $245.47 | Professional | 56 · Pre-op care only | $17.38 | $30.20 | $245.47 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $165.96 Median $269.15 Typical High $407.38 | Professional | 51 · Multiple procedures | $165.96 | $269.15 | $407.38 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $87.10 Typical High $128.82 | Professional | 80 · Assistant surgeon | $52.48 | $87.10 | $128.82 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $52.48 Median $87.10 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $52.48 | $87.10 | $128.82 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $52.48 Median $87.10 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $52.48 | $87.10 | $128.82 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $75.86 Typical High $112.20 | Professional | AS · PA/NP assist | $46.77 | $75.86 | $112.20 |
Where Wisconsin sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$617
AK $741KY $186
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.