How much rates vary
Facilitymedian $3,311 · 10th to 90th $427 to $7,943Professionalmedian $355 · 10th to 90th $129 to $1,096
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 $107.15 Median $229.09 Typical High $14,454.40 | Facility | None | $107.15 | $229.09 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $1,513.56 | Professional | None | $107.15 | $229.09 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $426.58 Typical High $1,258.93 | Professional | None | $138.04 | $426.58 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,071.52 Typical High $3,630.78 | Facility | None | $549.54 | $1,071.52 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $489.78 | Professional | None | $177.83 | $346.74 | $489.78 |
DeanCare Setting Facility Modifier None Typical Low $112.20 Median $2,570.40 Typical High $4,786.30 | Facility | None | $112.20 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $537.03 | Professional | None | $169.82 | $338.84 | $537.03 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $2,818.38 Typical High $8,317.64 | Facility | None | $338.84 | $2,818.38 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $831.76 Typical High $1,548.82 | Professional | None | $218.78 | $831.76 | $1,548.82 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $524.81 | Professional | None | $229.09 | $371.54 | $524.81 |
Prevea360 Setting Facility Modifier None Typical Low $89.13 Median $194.98 Typical High $426.58 | Facility | None | $89.13 | $194.98 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $758.58 | Professional | None | $154.88 | $407.38 | $758.58 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $3,981.07 | Facility | None | $630.96 | $2,398.83 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $389.05 | Professional | None | $181.97 | $251.19 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $794.33 | Professional | None | $354.81 | $354.81 | $794.33 |
Security Health Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $1,071.52 | Professional | None | $354.81 | $562.34 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $758.58 | Professional | None | $117.49 | $263.03 | $758.58 |
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 $53.70 Median $53.70 Typical High $114.82 | Facility | 52 · Reduced service | $53.70 | $53.70 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $45.71 | Facility | 53 · Discontinued | $21.38 | $21.38 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $173.78 | Facility | 54 · Surgery only | $79.43 | $79.43 | $173.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $34.67 | Facility | 55 · Aftercare only | $15.85 | $15.85 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $22.91 | Facility | 56 · Pre-op care only | $10.72 | $10.72 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $114.82 Typical High $741.31 | Professional | 52 · Reduced service | $53.70 | $114.82 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $45.71 Typical High $302.00 | Professional | 53 · Discontinued | $21.38 | $45.71 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $173.78 Typical High $1,122.02 | Professional | 54 · Surgery only | $79.43 | $173.78 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $34.67 Typical High $223.87 | Professional | 55 · Aftercare only | $15.85 | $34.67 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $22.91 Typical High $151.36 | Professional | 56 · Pre-op care only | $10.72 | $22.91 | $151.36 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $83.18 Median $169.82 Typical High $269.15 | Professional | 51 · Multiple procedures | $83.18 | $169.82 | $269.15 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.92 Median $54.95 Typical High $87.10 | Professional | 80 · Assistant surgeon | $26.92 | $54.95 | $87.10 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.92 Median $54.95 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $26.92 | $54.95 | $87.10 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.92 Median $54.95 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $26.92 | $54.95 | $87.10 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $23.44 Median $47.86 Typical High $75.86 | Professional | AS · PA/NP assist | $23.44 | $47.86 | $75.86 |
Where Wisconsin sits
The same service costs 4.0 times more in Alaska than in Washington, DC. 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 $468DC $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.