How much rates vary
Facilitymedian $1,230 · 10th to 90th $214 to $3,802Professionalmedian $479 · 10th to 90th $214 to $1,202
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 $154.88 Median $251.19 Typical High $14,454.40 | Facility | None | $154.88 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $1,905.46 | Professional | None | $154.88 | $251.19 | $1,905.46 |
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 $213.80 Median $562.34 Typical High $1,174.90 | Professional | None | $213.80 | $562.34 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $389.05 Typical High $812.83 | Facility | None | $50.12 | $389.05 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $1,047.13 | Professional | None | $281.84 | $457.09 | $1,047.13 |
DeanCare Setting Facility Modifier None Typical Low $177.83 Median $2,630.27 Typical High $5,128.61 | Facility | None | $177.83 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $676.08 | Professional | None | $288.40 | $457.09 | $676.08 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $912.01 Typical High $1,778.28 | Facility | None | $177.83 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $954.99 Typical High $1,862.09 | Professional | None | $257.04 | $954.99 | $1,862.09 |
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 $323.59 Median $489.78 Typical High $691.83 | Professional | None | $323.59 | $489.78 | $691.83 |
Prevea360 Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $478.63 | Facility | None | $151.36 | $245.47 | $478.63 |
Quartz Setting Professional Modifier None Typical Low $316.23 Median $630.96 Typical High $1,000.00 | Professional | None | $316.23 | $630.96 | $1,000.00 |
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 $281.84 Median $446.68 Typical High $549.54 | Professional | None | $281.84 | $446.68 | $549.54 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
Security Health Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,621.81 | Professional | None | $512.86 | $1,000.00 | $1,621.81 |
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 $181.97 Median $371.54 Typical High $1,023.29 | Professional | None | $181.97 | $371.54 | $1,023.29 |
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 $77.62 Median $77.62 Typical High $125.89 | Facility | 52 · Reduced service | $77.62 | $77.62 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $51.29 | Facility | 53 · Discontinued | $30.90 | $30.90 | $51.29 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $190.55 | Facility | 54 · Surgery only | $117.49 | $117.49 | $190.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $38.02 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $38.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $25.12 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $125.89 Typical High $954.99 | Professional | 52 · Reduced service | $77.62 | $125.89 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $51.29 Typical High $380.19 | Professional | 53 · Discontinued | $30.90 | $51.29 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $190.55 Typical High $1,445.44 | Professional | 54 · Surgery only | $117.49 | $190.55 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.02 Typical High $288.40 | Professional | 55 · Aftercare only | $23.44 | $38.02 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $25.12 Typical High $190.55 | Professional | 56 · Pre-op care only | $15.49 | $25.12 | $190.55 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $144.54 Median $229.09 Typical High $338.84 | Professional | 51 · Multiple procedures | $144.54 | $229.09 | $338.84 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $74.13 Typical High $109.65 | Professional | 80 · Assistant surgeon | $46.77 | $74.13 | $109.65 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $46.77 Median $74.13 Typical High $109.65 | Professional | 81 · Minimal assistant surgeon | $46.77 | $74.13 | $109.65 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $46.77 Median $74.13 Typical High $109.65 | Professional | 82 · Assistant surgeon, no resident | $46.77 | $74.13 | $109.65 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $64.57 Typical High $95.50 | Professional | AS · PA/NP assist | $40.74 | $64.57 | $95.50 |
Where Wisconsin sits
The same service costs 3.9 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
$537
AK $692MD $178
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.