How much rates vary
Facilitymedian $1,259 · 10th to 90th $275 to $4,365Professionalmedian $692 · 10th to 90th $257 to $1,413
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 $234.42 Median $288.40 Typical High $14,454.40 | Facility | None | $234.42 | $288.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $2,691.53 | Professional | None | $234.42 | $288.40 | $2,691.53 |
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 $302.00 Median $831.76 Typical High $1,513.56 | Professional | None | $302.00 | $831.76 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $537.03 Typical High $954.99 | Professional | 62 · Two surgeons | $208.93 | $537.03 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $131.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $48.98 | $131.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $117.49 Typical High $213.80 | Professional | AS · PA/NP assist | $42.66 | $117.49 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $588.84 Typical High $1,096.48 | Facility | None | $281.84 | $588.84 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $870.96 | Professional | None | $309.03 | $416.87 | $870.96 |
DeanCare Setting Facility Modifier None Typical Low $234.42 Median $4,265.80 Typical High $7,762.47 | Facility | None | $234.42 | $4,265.80 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $794.33 | Professional | None | $446.68 | $602.56 | $794.33 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $954.99 Typical High $2,089.30 | Facility | None | $229.09 | $954.99 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $616.60 Typical High $1,230.27 | Professional | None | $281.84 | $616.60 | $1,230.27 |
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 $371.54 Median $616.60 Typical High $741.31 | Professional | None | $371.54 | $616.60 | $741.31 |
Prevea360 Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $489.78 | Facility | None | $223.87 | $275.42 | $489.78 |
Quartz Setting Professional Modifier None Typical Low $295.12 Median $588.84 Typical High $891.25 | Professional | None | $295.12 | $588.84 | $891.25 |
Quartz Setting Facility Modifier None Typical Low $275.42 Median $416.87 Typical High $1,096.48 | Facility | None | $275.42 | $416.87 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $602.56 | Professional | None | $309.03 | $380.19 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | None | $269.15 | $269.15 | $338.84 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $1,659.59 | Professional | None | $229.09 | $316.23 | $1,659.59 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $245.47 Median $676.08 Typical High $1,071.52 | Professional | None | $245.47 | $676.08 | $1,071.52 |
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 Facility Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $144.54 | Facility | 52 · Reduced service | $117.49 | $117.49 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $57.54 | Facility | 53 · Discontinued | $46.77 | $46.77 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $218.78 | Facility | 54 · Surgery only | $177.83 | $177.83 | $218.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $43.65 | Facility | 55 · Aftercare only | $35.48 | $35.48 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $28.84 | Facility | 56 · Pre-op care only | $23.44 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $144.54 Typical High $1,348.96 | Professional | 52 · Reduced service | $117.49 | $144.54 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $57.54 Typical High $537.03 | Professional | 53 · Discontinued | $46.77 | $57.54 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $218.78 Typical High $1,995.26 | Professional | 54 · Surgery only | $177.83 | $218.78 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $398.11 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.84 Typical High $269.15 | Professional | 56 · Pre-op care only | $23.44 | $28.84 | $269.15 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 2nd of 51
$759
AK $851MD $229
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.