How much rates vary
Facilitymedian $1,862 · 10th to 90th $447 to $5,370Professionalmedian $1,259 · 10th to 90th $427 to $2,291
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 $323.59 Median $416.87 Typical High $14,454.40 | Facility | None | $323.59 | $416.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $4,466.84 | Professional | None | $323.59 | $416.87 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,412.54 Typical High $2,398.83 | Professional | None | $562.34 | $1,412.54 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $1,659.59 | Facility | None | $524.81 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,479.11 | Professional | None | $426.58 | $676.08 | $1,479.11 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $2,630.27 Typical High $5,128.61 | Facility | None | $416.87 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,318.26 | Professional | None | $660.69 | $870.96 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,479.11 Typical High $3,311.31 | Facility | None | $416.87 | $1,479.11 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,778.28 Typical High $3,630.78 | Professional | None | $562.34 | $1,778.28 | $3,630.78 |
Network Health Setting Facility Modifier None Typical Low $891.25 Median $1,819.70 Typical High $3,235.94 | Facility | None | $891.25 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,737.80 | Professional | None | $707.95 | $1,258.93 | $1,737.80 |
Prevea360 Setting Facility Modifier None Typical Low $346.74 Median $457.09 Typical High $1,023.29 | Facility | None | $346.74 | $457.09 | $1,023.29 |
Quartz Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $1,737.80 | Professional | None | $562.34 | $1,096.48 | $1,737.80 |
Quartz Setting Facility Modifier None Typical Low $501.19 Median $676.08 Typical High $1,096.48 | Facility | None | $501.19 | $676.08 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $977.24 | Professional | None | $426.58 | $562.34 | $977.24 |
Security Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | None | $676.08 | $676.08 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $1,819.70 Typical High $2,511.89 | Professional | None | $891.25 | $1,819.70 | $2,511.89 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,630.78 | Facility | None | $512.86 | $2,238.72 | $3,630.78 |
United Setting Professional Modifier None Typical Low $457.09 Median $1,096.48 Typical High $2,238.72 | Professional | None | $457.09 | $1,096.48 | $2,238.72 |
20 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 $158.49 Median $158.49 Typical High $208.93 | Facility | 52 · Reduced service | $158.49 | $158.49 | $208.93 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $83.18 | Facility | 53 · Discontinued | $64.57 | $64.57 | $83.18 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $316.23 | Facility | 54 · Surgery only | $239.88 | $239.88 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $63.10 | Facility | 55 · Aftercare only | $47.86 | $47.86 | $63.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $41.69 | Facility | 56 · Pre-op care only | $32.36 | $32.36 | $41.69 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $295.12 | Facility | 78 · Unplanned return to OR | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $208.93 Typical High $2,238.72 | Professional | 52 · Reduced service | $158.49 | $208.93 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $891.25 | Professional | 53 · Discontinued | $64.57 | $83.18 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $3,311.31 | Professional | 54 · Surgery only | $239.88 | $316.23 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $660.69 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $446.68 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $3,090.30 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $331.13 Median $426.58 Typical High $660.69 | Professional | 51 · Multiple procedures | $331.13 | $426.58 | $660.69 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $691.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $524.81 | $691.83 | $1,047.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $173.78 Typical High $263.03 | Professional | 55 · Aftercare only | $131.83 | $173.78 | $263.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $724.44 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $549.54 | $724.44 | $1,096.48 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $138.04 Typical High $208.93 | Professional | 80 · Assistant surgeon | $104.71 | $138.04 | $208.93 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $104.71 Median $138.04 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $104.71 | $138.04 | $208.93 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $104.71 Median $138.04 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $104.71 | $138.04 | $208.93 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $93.33 | $120.23 | $181.97 |
Where Wisconsin sits
The same service costs 5.1 times more in Alaska than in Texas. 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
$1,318
AK $1,514TX $295
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.