How much rates vary
Facilitymedian $1,202 · 10th to 90th $219 to $3,802Professionalmedian $589 · 10th to 90th $251 to $1,413
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 $181.97 Median $323.59 Typical High $14,454.40 | Facility | None | $181.97 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $2,137.96 | Professional | None | $181.97 | $323.59 | $2,137.96 |
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 $251.19 Median $616.60 Typical High $1,348.96 | Professional | None | $251.19 | $616.60 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $389.05 Typical High $1,047.13 | Facility | None | $50.12 | $389.05 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $1,318.26 | Professional | None | $316.23 | $588.84 | $1,318.26 |
DeanCare Setting Facility Modifier None Typical Low $213.80 Median $2,630.27 Typical High $5,128.61 | Facility | None | $213.80 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $870.96 | Professional | None | $346.74 | $575.44 | $870.96 |
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 $309.03 Median $1,202.26 Typical High $2,398.83 | Professional | None | $309.03 | $1,202.26 | $2,398.83 |
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 $407.38 Median $602.56 Typical High $812.83 | Professional | None | $407.38 | $602.56 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $602.56 | Facility | None | $181.97 | $302.00 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $1,288.25 | Professional | None | $389.05 | $758.58 | $1,288.25 |
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 $331.13 Median $501.19 Typical High $660.69 | Professional | None | $331.13 | $501.19 | $660.69 |
Security Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,000.00 | Professional | None | $588.84 | $588.84 | $1,000.00 |
Security Health Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,089.30 | Professional | None | $691.83 | $1,174.90 | $2,089.30 |
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 $213.80 Median $457.09 Typical High $1,288.25 | Professional | None | $213.80 | $457.09 | $1,288.25 |
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 $91.20 Median $91.20 Typical High $162.18 | Facility | 52 · Reduced service | $91.20 | $91.20 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $64.57 | Facility | 53 · Discontinued | $36.31 | $36.31 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $245.47 | Facility | 54 · Surgery only | $138.04 | $138.04 | $245.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $48.98 | Facility | 55 · Aftercare only | $27.54 | $27.54 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $32.36 | Facility | 56 · Pre-op care only | $18.20 | $18.20 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $162.18 Typical High $1,071.52 | Professional | 52 · Reduced service | $91.20 | $162.18 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $64.57 Typical High $426.58 | Professional | 53 · Discontinued | $36.31 | $64.57 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $245.47 Typical High $1,584.89 | Professional | 54 · Surgery only | $138.04 | $245.47 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $48.98 Typical High $323.59 | Professional | 55 · Aftercare only | $27.54 | $48.98 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $32.36 Typical High $213.80 | Professional | 56 · Pre-op care only | $18.20 | $32.36 | $213.80 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $173.78 Median $288.40 Typical High $436.52 | Professional | 51 · Multiple procedures | $173.78 | $288.40 | $436.52 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $93.33 Typical High $138.04 | Professional | 80 · Assistant surgeon | $54.95 | $93.33 | $138.04 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $93.33 Typical High $138.04 | Professional | 81 · Minimal assistant surgeon | $54.95 | $93.33 | $138.04 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $93.33 Typical High $138.04 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $93.33 | $138.04 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $81.28 Typical High $123.03 | Professional | AS · PA/NP assist | $47.86 | $81.28 | $123.03 |
Where Wisconsin sits
The same service costs 3.8 times more in Alaska 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.
Wisconsin· 2nd of 51
$617
AK $759MD $200
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.