How much rates vary
Facilitymedian $1,202 · 10th to 90th $89 to $3,802Professionalmedian $155 · 10th to 90th $65 to $513
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 $74.13 Typical High $14,454.40 | Facility | None | $40.74 | $74.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $831.76 | Professional | None | $40.74 | $74.13 | $831.76 |
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 $58.88 Median $173.78 Typical High $489.78 | Professional | None | $58.88 | $173.78 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $257.04 Typical High $691.83 | Professional | 50 · Both sides | $89.13 | $257.04 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $213.80 Typical High $707.95 | Facility | None | $87.10 | $213.80 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $354.81 | Professional | None | $85.11 | $154.88 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $64.57 Median $2,570.40 Typical High $4,786.30 | Facility | None | $64.57 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $239.88 | Professional | None | $81.28 | $141.25 | $239.88 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $213.80 Typical High $354.81 | Professional | 50 · Both sides | $123.03 | $213.80 | $354.81 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $912.01 Typical High $1,778.28 | Facility | None | $95.50 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $1,023.29 | Professional | None | $100.00 | $245.47 | $1,023.29 |
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 $74.13 Median $177.83 Typical High $331.13 | Professional | None | $74.13 | $177.83 | $331.13 |
Prevea360 Setting Facility Modifier None Typical Low $40.74 Median $89.13 Typical High $229.09 | Facility | None | $40.74 | $89.13 | $229.09 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $181.97 Typical High $389.05 | Professional | None | $85.11 | $181.97 | $389.05 |
Quartz Setting Facility Modifier None Typical Low $85.11 Median $131.83 Typical High $831.76 | Facility | None | $85.11 | $131.83 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $181.97 | Professional | None | $85.11 | $154.88 | $181.97 |
Security Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $288.40 | Professional | None | $154.88 | $154.88 | $288.40 |
Security Health Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $562.34 | Professional | None | $257.04 | $407.38 | $562.34 |
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 $66.07 Median $134.90 Typical High $389.05 | Professional | None | $66.07 | $134.90 | $389.05 |
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 $37.15 | Facility | 52 · Reduced service | $20.42 | $20.42 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $14.79 | Facility | 53 · Discontinued | $8.13 | $8.13 | $14.79 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $56.23 | Facility | 54 · Surgery only | $30.90 | $30.90 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $11.22 | Facility | 55 · Aftercare only | $6.17 | $6.17 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $7.41 | Facility | 56 · Pre-op care only | $4.07 | $4.07 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $37.15 Typical High $416.87 | Professional | 52 · Reduced service | $20.42 | $37.15 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $14.79 Typical High $165.96 | Professional | 53 · Discontinued | $8.13 | $14.79 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $56.23 Typical High $630.96 | Professional | 54 · Surgery only | $30.90 | $56.23 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.22 Typical High $125.89 | Professional | 55 · Aftercare only | $6.17 | $11.22 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.41 Typical High $83.18 | Professional | 56 · Pre-op care only | $4.07 | $7.41 | $83.18 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $40.74 Median $70.79 Typical High $120.23 | Professional | 51 · Multiple procedures | $40.74 | $70.79 | $120.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $13.18 Median $22.39 Typical High $38.02 | Professional | 80 · Assistant surgeon | $13.18 | $22.39 | $38.02 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $13.18 Median $22.39 Typical High $38.02 | Professional | 81 · Minimal assistant surgeon | $13.18 | $22.39 | $38.02 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $13.18 Median $22.39 Typical High $38.02 | Professional | 82 · Assistant surgeon, no resident | $13.18 | $22.39 | $38.02 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $11.48 Median $19.95 Typical High $33.11 | Professional | AS · PA/NP assist | $11.48 | $19.95 | $33.11 |
Where Wisconsin sits
The same service costs 3.0 times more in Alaska than in Virginia. 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
$174
AK $182VA $60.26
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.