How much rates vary
Facilitymedian $2,512 · 10th to 90th $100 to $18,197Professionalmedian $617 · 10th to 90th $105 to $2,570
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 $93.33 Median $691.83 Typical High $14,454.40 | Facility | None | $93.33 | $691.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $691.83 Typical High $1,230.27 | Professional | None | $93.33 | $691.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $478.63 Typical High $2,454.71 | Professional | None | $147.91 | $478.63 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $3,090.30 | Facility | None | $1,819.70 | $2,041.74 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $707.95 Typical High $1,778.28 | Professional | None | $97.72 | $707.95 | $1,778.28 |
DeanCare Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $933.25 | Facility | None | $100.00 | $186.21 | $933.25 |
DeanCare Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $1,659.59 | Professional | None | $162.18 | $281.84 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $3,548.13 Typical High $19,054.61 | Facility | None | $181.97 | $3,548.13 | $19,054.61 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $2,570.40 Typical High $4,677.35 | Professional | None | $323.59 | $2,570.40 | $4,677.35 |
Network Health Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $181.97 | Facility | None | $138.04 | $138.04 | $181.97 |
Network Health Setting Professional Modifier None Typical Low $194.98 Median $489.78 Typical High $1,122.02 | Professional | None | $194.98 | $489.78 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $933.25 | Facility | None | $100.00 | $186.21 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $128.82 Median $676.08 Typical High $1,819.70 | Professional | None | $128.82 | $676.08 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $97.72 Median $288.40 Typical High $851.14 | Professional | None | $97.72 | $288.40 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $891.25 | Professional | None | $112.20 | $112.20 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $229.09 Median $537.03 Typical High $3,548.13 | Professional | None | $229.09 | $537.03 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $7,244.36 Typical High $19,498.45 | Facility | None | $2,511.89 | $7,244.36 | $19,498.45 |
United Setting Professional Modifier None Typical Low $128.82 Median $363.08 Typical High $1,621.81 | Professional | None | $128.82 | $363.08 | $1,621.81 |
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 $46.77 Median $46.77 Typical High $338.84 | Facility | 52 · Reduced service | $46.77 | $46.77 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $138.04 | Facility | 53 · Discontinued | $18.62 | $18.62 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $512.86 | Facility | 54 · Surgery only | $70.79 | $70.79 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $102.33 | Facility | 55 · Aftercare only | $14.13 | $14.13 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $69.18 | Facility | 56 · Pre-op care only | $9.33 | $9.33 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $338.84 Typical High $616.60 | Professional | 52 · Reduced service | $46.77 | $338.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $138.04 Typical High $251.19 | Professional | 53 · Discontinued | $18.62 | $138.04 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $512.86 Typical High $933.25 | Professional | 54 · Surgery only | $70.79 | $512.86 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $102.33 Typical High $186.21 | Professional | 55 · Aftercare only | $14.13 | $102.33 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $69.18 Typical High $123.03 | Professional | 56 · Pre-op care only | $9.33 | $69.18 | $123.03 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $45.71 Typical High $269.15 | Professional | 80 · Assistant surgeon | $26.30 | $45.71 | $269.15 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $26.30 Median $45.71 Typical High $269.15 | Professional | 81 · Minimal assistant surgeon | $26.30 | $45.71 | $269.15 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $26.30 Median $45.71 Typical High $269.15 | Professional | 82 · Assistant surgeon, no resident | $26.30 | $45.71 | $269.15 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $39.81 Typical High $234.42 | Professional | AS · PA/NP assist | $22.91 | $39.81 | $234.42 |
Where Wisconsin sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 3rd of 51
$676
WA $933DC $97.72
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.