How much rates vary
Facilitymedian $120 · 10th to 90th $30 to $407Professionalmedian $115 · 10th to 90th $42 to $324
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 $30.20 Median $30.20 Typical High $120.23 | Facility | None | $30.20 | $30.20 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $120.23 Typical High $302.00 | Professional | None | $30.20 | $120.23 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $269.15 | Professional | None | $43.65 | $97.72 | $269.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $151.36 Typical High $398.11 | Professional | 50 · Both sides | $66.07 | $151.36 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $588.84 | Facility | None | $346.74 | $389.05 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $281.84 | Professional | None | $58.88 | $93.33 | $281.84 |
DeanCare Setting Facility Modifier None Typical Low $34.67 Median $66.07 Typical High $158.49 | Facility | None | $34.67 | $66.07 | $158.49 |
DeanCare Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $338.84 | Professional | None | $58.88 | $107.15 | $338.84 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $158.49 Typical High $512.86 | Professional | 50 · Both sides | $87.10 | $158.49 | $512.86 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $117.49 Typical High $1,348.96 | Facility | None | $34.67 | $117.49 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $501.19 Typical High $707.95 | Professional | None | $87.10 | $501.19 | $707.95 |
Network Health Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Facility | None | $50.12 | $50.12 | $69.18 |
Network Health Setting Professional Modifier None Typical Low $66.07 Median $114.82 Typical High $229.09 | Professional | None | $66.07 | $114.82 | $229.09 |
Prevea360 Setting Facility Modifier None Typical Low $34.67 Median $66.07 Typical High $158.49 | Facility | None | $34.67 | $66.07 | $158.49 |
Quartz Setting Professional Modifier None Typical Low $43.65 Median $131.83 Typical High $338.84 | Professional | None | $43.65 | $131.83 | $338.84 |
Quartz Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $251.19 | Professional | None | $61.66 | $81.28 | $251.19 |
Security Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $117.49 | Professional | None | $38.90 | $38.90 | $117.49 |
Security Health Setting Professional Modifier None Typical Low $54.95 Median $112.20 Typical High $309.03 | Professional | None | $54.95 | $112.20 | $309.03 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $42.66 Median $93.33 Typical High $199.53 | Professional | None | $42.66 | $93.33 | $199.53 |
8 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 $15.14 Median $15.14 Typical High $60.26 | Facility | 52 · Reduced service | $15.14 | $15.14 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $23.99 | Facility | 53 · Discontinued | $6.03 | $6.03 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $60.26 Typical High $151.36 | Professional | 52 · Reduced service | $15.14 | $60.26 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $23.99 Typical High $60.26 | Professional | 53 · Discontinued | $6.03 | $23.99 | $60.26 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $9.33 Median $16.98 Typical High $54.95 | Professional | 80 · Assistant surgeon | $9.33 | $16.98 | $54.95 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $9.33 Median $16.98 Typical High $54.95 | Professional | 81 · Minimal assistant surgeon | $9.33 | $16.98 | $54.95 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $9.33 Median $16.98 Typical High $54.95 | Professional | 82 · Assistant surgeon, no resident | $9.33 | $16.98 | $54.95 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $8.13 Median $14.79 Typical High $47.86 | Professional | AS · PA/NP assist | $8.13 | $14.79 | $47.86 |
Where Wisconsin sits
The same service costs 4.2 times more in Washington 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· 4th of 51
$115
WA $186MD $44.67
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.