How much rates vary
Facilitymedian $1,318 · 10th to 90th $100 to $3,162Professionalmedian $309 · 10th to 90th $98 to $1,122
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 $89.13 Median $223.87 Typical High $14,454.40 | Facility | None | $89.13 | $223.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $223.87 Typical High $1,348.96 | Professional | None | $89.13 | $223.87 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $346.74 Typical High $1,174.90 | Professional | None | $107.15 | $346.74 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $512.86 Typical High $758.58 | Facility | None | $446.68 | $512.86 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $549.54 | Professional | None | $120.23 | $239.88 | $549.54 |
DeanCare Setting Facility Modifier None Typical Low $104.71 Median $2,754.23 Typical High $5,128.61 | Facility | None | $104.71 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $446.68 | Professional | None | $114.82 | $251.19 | $446.68 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $1,318.26 Typical High $1,778.28 | Facility | None | $131.83 | $1,318.26 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $660.69 Typical High $1,258.93 | Professional | None | $251.19 | $660.69 | $1,258.93 |
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 $186.21 Median $239.88 Typical High $616.60 | Professional | None | $186.21 | $239.88 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $154.88 Typical High $346.74 | Facility | None | $72.44 | $154.88 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $112.20 Median $281.84 Typical High $724.44 | Professional | None | $112.20 | $281.84 | $724.44 |
Quartz Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $380.19 | Professional | None | $125.89 | $234.42 | $380.19 |
Security Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $891.25 | Professional | None | $346.74 | $346.74 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $363.08 Median $851.14 Typical High $1,258.93 | Professional | None | $363.08 | $851.14 | $1,258.93 |
The Alliance Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $501.19 | Professional | None | $354.81 | $354.81 | $501.19 |
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 $91.20 Median $275.42 Typical High $794.33 | Professional | None | $91.20 | $275.42 | $794.33 |
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 $44.67 Median $44.67 Typical High $112.20 | Facility | 52 · Reduced service | $44.67 | $44.67 | $112.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $44.67 | Facility | 53 · Discontinued | $17.78 | $17.78 | $44.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $169.82 | Facility | 54 · Surgery only | $66.07 | $66.07 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $33.88 | Facility | 55 · Aftercare only | $13.18 | $13.18 | $33.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $22.39 | Facility | 56 · Pre-op care only | $8.91 | $8.91 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $112.20 Typical High $676.08 | Professional | 52 · Reduced service | $44.67 | $112.20 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $44.67 Typical High $275.42 | Professional | 53 · Discontinued | $17.78 | $44.67 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $169.82 Typical High $1,023.29 | Professional | 54 · Surgery only | $66.07 | $169.82 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $33.88 Typical High $204.17 | Professional | 55 · Aftercare only | $13.18 | $33.88 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $22.39 Typical High $138.04 | Professional | 56 · Pre-op care only | $8.91 | $22.39 | $138.04 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $72.44 Median $158.49 Typical High $281.84 | Professional | 62 · Two surgeons | $72.44 | $158.49 | $281.84 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $39.81 Typical High $72.44 | Professional | 80 · Assistant surgeon | $18.62 | $39.81 | $72.44 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $18.62 Median $39.81 Typical High $72.44 | Professional | 81 · Minimal assistant surgeon | $18.62 | $39.81 | $72.44 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $18.62 Median $39.81 Typical High $72.44 | Professional | 82 · Assistant surgeon, no resident | $18.62 | $39.81 | $72.44 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $34.67 Typical High $63.10 | Professional | AS · PA/NP assist | $16.22 | $34.67 | $63.10 |
Where Wisconsin sits
The same service costs 2.7 times more in Wisconsin 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· 1st of 51
$316
WI $316UT $117
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.