How much rates vary
Facilitymedian $1,259 · 10th to 90th $89 to $2,818Professionalmedian $372 · 10th to 90th $71 to $1,698
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 $60.26 Median $323.59 Typical High $14,454.40 | Facility | None | $60.26 | $323.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $323.59 Typical High $1,621.81 | Professional | None | $60.26 | $323.59 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $380.19 Typical High $1,819.70 | Professional | None | $89.13 | $380.19 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $562.34 Typical High $2,630.27 | Professional | 50 · Both sides | $131.83 | $562.34 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $741.31 Typical High $1,122.02 | Facility | None | $660.69 | $741.31 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $331.13 Typical High $912.01 | Professional | None | $79.43 | $331.13 | $912.01 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $2,754.23 Typical High $5,128.61 | Facility | None | $72.44 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $676.08 | Professional | None | $83.18 | $158.49 | $676.08 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $239.88 Typical High $1,000.00 | Professional | 50 · Both sides | $123.03 | $239.88 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $1,318.26 Typical High $1,778.28 | Facility | None | $100.00 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $933.25 Typical High $2,290.87 | Professional | None | $416.87 | $933.25 | $2,290.87 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,344.23 | Facility | None | $831.76 | $1,819.70 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $109.65 Median $407.38 Typical High $933.25 | Professional | None | $109.65 | $407.38 | $933.25 |
Prevea360 Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $501.19 | Facility | None | $50.12 | $100.00 | $501.19 |
Quartz Setting Professional Modifier None Typical Low $72.44 Median $269.15 Typical High $1,071.52 | Professional | None | $72.44 | $269.15 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $501.19 | Professional | None | $79.43 | $173.78 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $1,412.54 | Professional | None | $239.88 | $239.88 | $1,412.54 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $2,041.74 | Professional | None | $269.15 | $371.54 | $2,041.74 |
The Alliance Setting Professional Modifier None Typical Low $69.18 Median $199.53 Typical High $275.42 | Professional | None | $69.18 | $199.53 | $275.42 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $70.79 Median $288.40 Typical High $1,288.25 | Professional | None | $70.79 | $288.40 | $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 $30.20 Median $30.20 Typical High $162.18 | Facility | 52 · Reduced service | $30.20 | $30.20 | $162.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $64.57 | Facility | 53 · Discontinued | $12.02 | $12.02 | $64.57 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $239.88 | Facility | 54 · Surgery only | $45.71 | $45.71 | $239.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $48.98 | Facility | 55 · Aftercare only | $9.12 | $9.12 | $48.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $32.36 | Facility | 56 · Pre-op care only | $6.03 | $6.03 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $162.18 Typical High $954.99 | Professional | 52 · Reduced service | $30.20 | $162.18 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $64.57 Typical High $380.19 | Professional | 53 · Discontinued | $12.02 | $64.57 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $239.88 Typical High $1,445.44 | Professional | 54 · Surgery only | $45.71 | $239.88 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $48.98 Typical High $288.40 | Professional | 55 · Aftercare only | $9.12 | $48.98 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $32.36 Typical High $190.55 | Professional | 56 · Pre-op care only | $6.03 | $32.36 | $190.55 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $41.69 Median $79.43 Typical High $331.13 | Professional | 51 · Multiple procedures | $41.69 | $79.43 | $331.13 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $25.70 Typical High $107.15 | Professional | 80 · Assistant surgeon | $13.18 | $25.70 | $107.15 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $25.70 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $13.18 | $25.70 | $107.15 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $25.70 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $25.70 | $107.15 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $11.75 Median $22.39 Typical High $93.33 | Professional | AS · PA/NP assist | $11.75 | $22.39 | $93.33 |
Where Wisconsin sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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
$389
IA $417NE $85.11
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.