How much rates vary
Facilitymedian $1,202 · 10th to 90th $107 to $3,802Professionalmedian $200 · 10th to 90th $87 to $513
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 $67.61 Median $100.00 Typical High $14,454.40 | Facility | None | $67.61 | $100.00 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $831.76 | Professional | None | $67.61 | $100.00 | $831.76 |
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 $91.20 Median $229.09 Typical High $501.19 | Professional | None | $91.20 | $229.09 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $199.53 Typical High $323.59 | Facility | None | $50.12 | $199.53 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $416.87 | Professional | None | $114.82 | $181.97 | $416.87 |
DeanCare Setting Facility Modifier None Typical Low $75.86 Median $2,630.27 Typical High $5,128.61 | Facility | None | $75.86 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $269.15 | Professional | None | $128.82 | $186.21 | $269.15 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $912.01 Typical High $1,778.28 | Facility | None | $120.23 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $380.19 Typical High $758.58 | Professional | None | $100.00 | $380.19 | $758.58 |
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 $128.82 Median $204.17 Typical High $288.40 | Professional | None | $128.82 | $204.17 | $288.40 |
Prevea360 Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $190.55 | Facility | None | $64.57 | $97.72 | $190.55 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $398.11 | Professional | None | $125.89 | $263.03 | $398.11 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $144.54 Typical High $218.78 | Facility | None | $50.12 | $144.54 | $218.78 |
Quartz Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $208.93 | Professional | None | $123.03 | $181.97 | $208.93 |
Security Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $316.23 | Professional | None | $218.78 | $218.78 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $181.97 Median $436.52 Typical High $645.65 | Professional | None | $181.97 | $436.52 | $645.65 |
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 $77.62 Median $154.88 Typical High $436.52 | Professional | None | $77.62 | $154.88 | $436.52 |
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 $33.88 Median $33.88 Typical High $50.12 | Facility | 52 · Reduced service | $33.88 | $33.88 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $20.42 | Facility | 53 · Discontinued | $13.80 | $13.80 | $20.42 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $75.86 | Facility | 54 · Surgery only | $51.29 | $51.29 | $75.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $15.14 | Facility | 55 · Aftercare only | $10.23 | $10.23 | $15.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $10.00 | Facility | 56 · Pre-op care only | $6.76 | $6.76 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $50.12 Typical High $407.38 | Professional | 52 · Reduced service | $33.88 | $50.12 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $20.42 Typical High $165.96 | Professional | 53 · Discontinued | $13.80 | $20.42 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $75.86 Typical High $616.60 | Professional | 54 · Surgery only | $51.29 | $75.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.14 Typical High $123.03 | Professional | 55 · Aftercare only | $10.23 | $15.14 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.00 Typical High $83.18 | Professional | 56 · Pre-op care only | $6.76 | $10.00 | $83.18 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $64.57 Median $93.33 Typical High $134.90 | Professional | 51 · Multiple procedures | $64.57 | $93.33 | $134.90 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $29.51 Typical High $43.65 | Professional | 80 · Assistant surgeon | $20.42 | $29.51 | $43.65 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $29.51 Typical High $43.65 | Professional | 81 · Minimal assistant surgeon | $20.42 | $29.51 | $43.65 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $29.51 Typical High $43.65 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $29.51 | $43.65 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $26.30 Typical High $38.02 | Professional | AS · PA/NP assist | $17.78 | $26.30 | $38.02 |
Where Wisconsin sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$219
AK $282FL $74.13
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.