How much rates vary
Facilitymedian $1,318 · 10th to 90th $324 to $3,802Professionalmedian $1,096 · 10th to 90th $407 to $2,042
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 $309.03 Median $389.05 Typical High $14,454.40 | Facility | None | $309.03 | $389.05 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $3,467.37 | Professional | None | $309.03 | $389.05 | $3,467.37 |
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 $524.81 Median $1,318.26 Typical High $2,041.74 | Professional | None | $524.81 | $1,318.26 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $676.08 Typical High $1,621.81 | Facility | None | $371.54 | $676.08 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,513.56 | Professional | None | $407.38 | $616.60 | $1,513.56 |
DeanCare Setting Facility Modifier None Typical Low $398.11 Median $2,630.27 Typical High $5,128.61 | Facility | None | $398.11 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,230.27 | Professional | None | $630.96 | $794.33 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $933.25 Typical High $1,778.28 | Facility | None | $218.78 | $933.25 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,548.82 Typical High $3,388.44 | Professional | None | $489.78 | $1,548.82 | $3,388.44 |
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 $630.96 Median $1,047.13 Typical High $1,348.96 | Professional | None | $630.96 | $1,047.13 | $1,348.96 |
Prevea360 Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $933.25 | Facility | None | $331.13 | $446.68 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,548.82 | Professional | None | $537.03 | $1,000.00 | $1,548.82 |
Quartz Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $1,096.48 | Facility | None | $363.08 | $489.78 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $891.25 | Professional | None | $380.19 | $512.86 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $794.33 Median $1,698.24 Typical High $2,187.76 | Professional | None | $794.33 | $1,698.24 | $2,187.76 |
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 $407.38 Median $933.25 Typical High $1,905.46 | Professional | None | $407.38 | $933.25 | $1,905.46 |
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 $154.88 Median $154.88 Typical High $194.98 | Facility | 52 · Reduced service | $154.88 | $154.88 | $194.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $77.62 | Facility | 53 · Discontinued | $61.66 | $61.66 | $77.62 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $295.12 | Facility | 54 · Surgery only | $229.09 | $229.09 | $295.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $58.88 | Facility | 55 · Aftercare only | $46.77 | $46.77 | $58.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $38.90 | Facility | 56 · Pre-op care only | $30.90 | $30.90 | $38.90 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | 78 · Unplanned return to OR | $213.80 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $194.98 Typical High $1,737.80 | Professional | 52 · Reduced service | $154.88 | $194.98 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $691.83 | Professional | 53 · Discontinued | $61.66 | $77.62 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $295.12 Typical High $2,570.40 | Professional | 54 · Surgery only | $229.09 | $295.12 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $58.88 Typical High $512.86 | Professional | 55 · Aftercare only | $46.77 | $58.88 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $346.74 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $2,398.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $398.11 Typical High $616.60 | Professional | 51 · Multiple procedures | $316.23 | $398.11 | $616.60 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $512.86 | $645.65 | $977.24 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $158.49 Typical High $245.47 | Professional | 55 · Aftercare only | $125.89 | $158.49 | $245.47 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $676.08 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $537.03 | $676.08 | $1,023.29 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $128.82 Typical High $194.98 | Professional | 80 · Assistant surgeon | $102.33 | $128.82 | $194.98 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $128.82 Typical High $194.98 | Professional | 81 · Minimal assistant surgeon | $102.33 | $128.82 | $194.98 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $128.82 Typical High $194.98 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $128.82 | $194.98 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $112.20 Typical High $169.82 | Professional | AS · PA/NP assist | $89.13 | $112.20 | $169.82 |
Where Wisconsin sits
The same service costs 6.0 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
$1,148
AK $1,445TX $240
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.