How much rates vary
Facilitymedian $158 · 10th to 90th $68 to $759Professionalmedian $214 · 10th to 90th $79 to $589
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 $67.61 Median $158.49 Typical High $14,454.40 | Facility | None | $67.61 | $158.49 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $870.96 | Professional | None | $67.61 | $158.49 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $512.86 | Professional | None | $102.33 | $223.87 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $691.83 | Facility | None | $407.38 | $467.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $426.58 | Professional | None | $79.43 | $181.97 | $426.58 |
DeanCare Setting Facility Modifier None Typical Low $72.44 Median $134.90 Typical High $269.15 | Facility | None | $72.44 | $134.90 | $269.15 |
DeanCare Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $426.58 | Professional | None | $123.03 | $223.87 | $426.58 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $131.83 Typical High $269.15 | Facility | None | $69.18 | $131.83 | $269.15 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $549.54 Typical High $933.25 | Professional | None | $190.55 | $549.54 | $933.25 |
Network Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $134.90 | Facility | None | $97.72 | $97.72 | $134.90 |
Network Health Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $380.19 | Professional | None | $154.88 | $229.09 | $380.19 |
Prevea360 Setting Facility Modifier None Typical Low $72.44 Median $134.90 Typical High $269.15 | Facility | None | $72.44 | $134.90 | $269.15 |
Quartz Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $478.63 | Professional | None | $85.11 | $199.53 | $478.63 |
Quartz Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $245.47 | Professional | None | $79.43 | $162.18 | $245.47 |
Security Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $181.97 | Professional | None | $81.28 | $81.28 | $181.97 |
Security Health Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $870.96 | Professional | None | $204.17 | $389.05 | $870.96 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $562.34 | Professional | None | $100.00 | $223.87 | $562.34 |
14 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 $33.88 Median $33.88 Typical High $77.62 | Facility | 52 · Reduced service | $33.88 | $33.88 | $77.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $31.62 | Facility | 53 · Discontinued | $13.49 | $13.49 | $31.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $117.49 | Facility | 54 · Surgery only | $51.29 | $51.29 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $23.44 | Facility | 55 · Aftercare only | $10.23 | $10.23 | $23.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $15.85 | Facility | 56 · Pre-op care only | $6.76 | $6.76 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $77.62 Typical High $436.52 | Professional | 52 · Reduced service | $33.88 | $77.62 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $31.62 Typical High $173.78 | Professional | 53 · Discontinued | $13.49 | $31.62 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $117.49 Typical High $645.65 | Professional | 54 · Surgery only | $51.29 | $117.49 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $23.44 Typical High $128.82 | Professional | 55 · Aftercare only | $10.23 | $23.44 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $15.85 Typical High $87.10 | Professional | 56 · Pre-op care only | $6.76 | $15.85 | $87.10 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $35.48 Typical High $67.61 | Professional | 80 · Assistant surgeon | $19.50 | $35.48 | $67.61 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.50 Median $35.48 Typical High $67.61 | Professional | 81 · Minimal assistant surgeon | $19.50 | $35.48 | $67.61 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.50 Median $35.48 Typical High $67.61 | Professional | 82 · Assistant surgeon, no resident | $19.50 | $35.48 | $67.61 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $30.90 Typical High $58.88 | Professional | AS · PA/NP assist | $16.98 | $30.90 | $58.88 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$209
AK $263KY $75.86
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.