How much rates vary
Facilitymedian $1,259 · 10th to 90th $72 to $2,818Professionalmedian $234 · 10th to 90th $56 to $977
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 $40.74 Median $194.98 Typical High $14,454.40 | Facility | None | $40.74 | $194.98 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $194.98 Typical High $588.84 | Professional | None | $40.74 | $194.98 | $588.84 |
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 $70.79 Median $269.15 Typical High $1,148.15 | Professional | None | $70.79 | $269.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $537.03 Typical High $812.83 | Facility | None | $478.63 | $537.03 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $165.96 Typical High $676.08 | Professional | None | $69.18 | $165.96 | $676.08 |
DeanCare Setting Facility Modifier None Typical Low $63.10 Median $2,754.23 Typical High $5,128.61 | Facility | None | $63.10 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $489.78 | Professional | None | $66.07 | $125.89 | $489.78 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $1,318.26 Typical High $2,041.74 | Facility | None | $77.62 | $1,318.26 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $660.69 Typical High $1,318.26 | Professional | None | $186.21 | $660.69 | $1,318.26 |
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 $89.13 Median $257.04 Typical High $467.74 | Professional | None | $89.13 | $257.04 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $39.81 Median $77.62 Typical High $309.03 | Facility | None | $39.81 | $77.62 | $309.03 |
Quartz Setting Professional Modifier None Typical Low $56.23 Median $190.55 Typical High $676.08 | Professional | None | $56.23 | $190.55 | $676.08 |
Quartz Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $389.05 | Professional | None | $69.18 | $144.54 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $707.95 | Professional | None | $138.04 | $138.04 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $1,000.00 | Professional | None | $144.54 | $269.15 | $1,000.00 |
The Alliance Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $223.87 | Professional | None | $56.23 | $151.36 | $223.87 |
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 $56.23 Median $190.55 Typical High $776.25 | Professional | None | $56.23 | $190.55 | $776.25 |
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 $20.42 Median $20.42 Typical High $97.72 | Facility | 52 · Reduced service | $20.42 | $20.42 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $38.90 | Facility | 53 · Discontinued | $8.13 | $8.13 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $144.54 | Facility | 54 · Surgery only | $30.20 | $30.20 | $144.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $28.84 | Facility | 55 · Aftercare only | $6.03 | $6.03 | $28.84 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $19.50 | Facility | 56 · Pre-op care only | $4.07 | $4.07 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $97.72 Typical High $323.59 | Professional | 52 · Reduced service | $20.42 | $97.72 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $38.90 Typical High $128.82 | Professional | 53 · Discontinued | $8.13 | $38.90 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $144.54 Typical High $489.78 | Professional | 54 · Surgery only | $30.20 | $144.54 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $28.84 Typical High $97.72 | Professional | 55 · Aftercare only | $6.03 | $28.84 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $19.50 Typical High $64.57 | Professional | 56 · Pre-op care only | $4.07 | $19.50 | $64.57 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $33.11 Median $63.10 Typical High $239.88 | Professional | 51 · Multiple procedures | $33.11 | $63.10 | $239.88 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.72 Median $19.95 Typical High $77.62 | Professional | 80 · Assistant surgeon | $10.72 | $19.95 | $77.62 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $10.72 Median $19.95 Typical High $77.62 | Professional | 81 · Minimal assistant surgeon | $10.72 | $19.95 | $77.62 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $10.72 Median $19.95 Typical High $77.62 | Professional | 82 · Assistant surgeon, no resident | $10.72 | $19.95 | $77.62 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $9.33 Median $17.38 Typical High $67.61 | Professional | AS · PA/NP assist | $9.33 | $17.38 | $67.61 |
Where Wisconsin sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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
$251
WI $251MI $56.23
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.