How much rates vary
Facilitymedian $1,202 · 10th to 90th $204 to $3,548Professionalmedian $417 · 10th to 90th $182 to $1,072
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 $134.90 Median $134.90 Typical High $229.09 | Facility | None | $134.90 | $134.90 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $3,388.44 | Professional | None | $134.90 | $229.09 | $3,388.44 |
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 $181.97 Median $489.78 Typical High $1,023.29 | Professional | None | $181.97 | $489.78 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $389.05 Typical High $724.44 | Facility | None | $50.12 | $389.05 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $933.25 | Professional | None | $245.47 | $416.87 | $933.25 |
DeanCare Setting Facility Modifier None Typical Low $162.18 Median $2,630.27 Typical High $5,128.61 | Facility | None | $162.18 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $616.60 | Professional | None | $251.19 | $407.38 | $616.60 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $912.01 Typical High $1,778.28 | Facility | None | $173.78 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $851.14 Typical High $1,698.24 | Professional | None | $229.09 | $851.14 | $1,698.24 |
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 $288.40 Median $426.58 Typical High $616.60 | Professional | None | $288.40 | $426.58 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $426.58 | Facility | None | $131.83 | $218.78 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $912.01 | Professional | None | $288.40 | $562.34 | $912.01 |
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 $245.47 Median $398.11 Typical High $501.19 | Professional | None | $245.47 | $398.11 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Professional | None | $436.52 | $436.52 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $446.68 Median $870.96 Typical High $1,479.11 | Professional | None | $446.68 | $870.96 | $1,479.11 |
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 $158.49 Median $331.13 Typical High $912.01 | Professional | None | $158.49 | $331.13 | $912.01 |
13 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 $67.61 Median $67.61 Typical High $114.82 | Facility | 52 · Reduced service | $67.61 | $67.61 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $45.71 | Facility | 53 · Discontinued | $26.92 | $26.92 | $45.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $34.67 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $22.91 | Facility | 56 · Pre-op care only | $13.49 | $13.49 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $114.82 Typical High $1,698.24 | Professional | 52 · Reduced service | $67.61 | $114.82 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $45.71 Typical High $676.08 | Professional | 53 · Discontinued | $26.92 | $45.71 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $34.67 Typical High $501.19 | Professional | 55 · Aftercare only | $19.95 | $34.67 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $22.91 Typical High $338.84 | Professional | 56 · Pre-op care only | $13.49 | $22.91 | $338.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $125.89 Median $204.17 Typical High $309.03 | Professional | 51 · Multiple procedures | $125.89 | $204.17 | $309.03 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $66.07 Typical High $97.72 | Professional | 80 · Assistant surgeon | $40.74 | $66.07 | $97.72 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $40.74 Median $66.07 Typical High $97.72 | Professional | 81 · Minimal assistant surgeon | $40.74 | $66.07 | $97.72 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $40.74 Median $66.07 Typical High $97.72 | Professional | 82 · Assistant surgeon, no resident | $40.74 | $66.07 | $97.72 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $57.54 Typical High $87.10 | Professional | AS · PA/NP assist | $35.48 | $57.54 | $87.10 |
Where Wisconsin sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.