How much rates vary
Facilitymedian $1,349 · 10th to 90th $282 to $3,802Professionalmedian $331 · 10th to 90th $170 to $1,479
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 $223.87 Median $1,905.46 Typical High $14,454.40 | Facility | None | $223.87 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $2,818.38 | Professional | None | $194.98 | $223.87 | $2,818.38 |
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 $169.82 Median $562.34 Typical High $1,288.25 | Professional | None | $169.82 | $562.34 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $501.19 Typical High $812.83 | Facility | None | $407.38 | $501.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $616.60 | Professional | None | $245.47 | $316.23 | $616.60 |
DeanCare Setting Facility Modifier None Typical Low $186.21 Median $2,818.38 Typical High $5,128.61 | Facility | None | $186.21 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $562.34 | Professional | None | $295.12 | $346.74 | $562.34 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $1,000.00 Typical High $1,778.28 | Facility | None | $204.17 | $1,000.00 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $645.65 Typical High $1,698.24 | Professional | None | $154.88 | $645.65 | $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 $239.88 Median $251.19 Typical High $537.03 | Professional | None | $239.88 | $251.19 | $537.03 |
Prevea360 Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $346.74 | Facility | None | $154.88 | $199.53 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $741.31 | Professional | None | $158.49 | $331.13 | $741.31 |
Quartz Setting Facility Modifier None Typical Low $398.11 Median $537.03 Typical High $1,071.52 | Facility | None | $398.11 | $537.03 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $398.11 | Professional | None | $269.15 | $316.23 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,258.93 | Professional | None | $616.60 | $1,000.00 | $1,258.93 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,174.90 Typical High $1,862.09 | Facility | None | $218.78 | $1,174.90 | $1,862.09 |
United Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $794.33 | Professional | None | $144.54 | $281.84 | $794.33 |
10 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 Professional Modifier 52 · Reduced service Typical Low $97.72 Median $112.20 Typical High $1,412.54 | Professional | 52 · Reduced service | $97.72 | $112.20 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $562.34 | Professional | 53 · Discontinued | $38.90 | $44.67 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $2,137.96 | Professional | 54 · Surgery only | $144.54 | $169.82 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $426.58 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $281.84 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $281.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $147.91 Median $173.78 Typical High $281.84 | Professional | 51 · Multiple procedures | $147.91 | $173.78 | $281.84 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $54.95 Typical High $89.13 | Professional | 80 · Assistant surgeon | $46.77 | $54.95 | $89.13 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $46.77 Median $54.95 Typical High $89.13 | Professional | 81 · Minimal assistant surgeon | $46.77 | $54.95 | $89.13 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $46.77 Median $54.95 Typical High $89.13 | Professional | 82 · Assistant surgeon, no resident | $46.77 | $54.95 | $89.13 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $48.98 Typical High $79.43 | Professional | AS · PA/NP assist | $41.69 | $48.98 | $79.43 |
Where Wisconsin sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 3rd of 51
$389
AK $603UT $132
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.