How much rates vary
Facilitymedian $1,514 · 10th to 90th $234 to $4,266Professionalmedian $200 · 10th to 90th $115 to $724
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 $128.82 Median $1,905.46 Typical High $14,454.40 | Facility | None | $128.82 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $1,258.93 | Professional | None | $114.82 | $128.82 | $1,258.93 |
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 $104.71 Median $323.59 Typical High $831.76 | Professional | None | $104.71 | $323.59 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $1,479.11 | Facility | None | $251.19 | $295.12 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $346.74 | Professional | None | $158.49 | $181.97 | $346.74 |
DeanCare Setting Facility Modifier None Typical Low $112.20 Median $2,818.38 Typical High $5,370.32 | Facility | None | $112.20 | $2,818.38 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $354.81 | Professional | None | $169.82 | $199.53 | $354.81 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $954.99 Typical High $1,778.28 | Facility | None | $154.88 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $354.81 Typical High $724.44 | Professional | None | $128.82 | $354.81 | $724.44 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $354.81 | Professional | None | $107.15 | $199.53 | $354.81 |
Prevea360 Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $213.80 | Facility | None | $89.13 | $112.20 | $213.80 |
Quartz Setting Professional Modifier None Typical Low $91.20 Median $186.21 Typical High $416.87 | Professional | None | $91.20 | $186.21 | $416.87 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $1,659.59 | Facility | None | $645.65 | $954.99 | $1,659.59 |
Quartz Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $229.09 | Professional | None | $169.82 | $181.97 | $229.09 |
Security Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Security Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $724.44 | Professional | None | $537.03 | $676.08 | $724.44 |
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 $107.15 Median $190.55 Typical High $467.74 | Professional | None | $107.15 | $190.55 | $467.74 |
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 $57.54 Median $64.57 Typical High $602.56 | Professional | 52 · Reduced service | $57.54 | $64.57 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.70 Typical High $239.88 | Professional | 53 · Discontinued | $22.91 | $25.70 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $97.72 Typical High $891.25 | Professional | 54 · Surgery only | $85.11 | $97.72 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $177.83 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $120.23 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $120.23 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $85.11 Median $100.00 Typical High $177.83 | Professional | 51 · Multiple procedures | $85.11 | $100.00 | $177.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $31.62 Typical High $57.54 | Professional | 80 · Assistant surgeon | $26.92 | $31.62 | $57.54 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $31.62 Typical High $57.54 | Professional | 81 · Minimal assistant surgeon | $26.92 | $31.62 | $57.54 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $31.62 Typical High $57.54 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $31.62 | $57.54 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $27.54 Typical High $50.12 | Professional | AS · PA/NP assist | $23.44 | $27.54 | $50.12 |
Where Wisconsin sits
The same service costs 4.0 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· 3rd of 51
$234
AK $372FL $93.33
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.