How much rates vary
Facilitymedian $1,950 · 10th to 90th $288 to $4,467Professionalmedian $776 · 10th to 90th $288 to $1,549
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 $181.97 Median $288.40 Typical High $14,454.40 | Facility | None | $181.97 | $288.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $2,630.27 | Professional | None | $181.97 | $288.40 | $2,630.27 |
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 $389.05 Median $831.76 Typical High $1,548.82 | Professional | None | $389.05 | $831.76 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $912.01 Typical High $1,380.38 | Facility | None | $50.12 | $912.01 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $1,023.29 | Professional | None | $245.47 | $416.87 | $1,023.29 |
DeanCare Setting Facility Modifier None Typical Low $234.42 Median $2,630.27 Typical High $5,128.61 | Facility | None | $234.42 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $891.25 | Professional | None | $380.19 | $588.84 | $891.25 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,412.54 Typical High $3,019.95 | Facility | None | $371.54 | $1,412.54 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $1,288.25 Typical High $2,511.89 | Professional | None | $398.11 | $1,288.25 | $2,511.89 |
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 $489.78 Median $776.25 Typical High $1,230.27 | Professional | None | $489.78 | $776.25 | $1,230.27 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $309.03 Typical High $691.83 | Facility | None | $190.55 | $309.03 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $1,258.93 | Professional | None | $363.08 | $724.44 | $1,258.93 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $66.07 | Facility | None | $50.12 | $50.12 | $66.07 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $602.56 | Professional | None | $245.47 | $380.19 | $602.56 |
Security Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $630.96 | Professional | None | $389.05 | $389.05 | $630.96 |
Security Health Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,778.28 | Professional | None | $588.84 | $1,047.13 | $1,778.28 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $269.15 Median $676.08 Typical High $1,584.89 | Professional | None | $269.15 | $676.08 | $1,584.89 |
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 $91.20 Median $91.20 Typical High $144.54 | Facility | 52 · Reduced service | $91.20 | $91.20 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $57.54 | Facility | 53 · Discontinued | $36.31 | $36.31 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $213.80 | Facility | 54 · Surgery only | $138.04 | $138.04 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $42.66 | Facility | 55 · Aftercare only | $27.54 | $27.54 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $28.84 | Facility | 56 · Pre-op care only | $18.20 | $18.20 | $28.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $128.82 | $128.82 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $144.54 Typical High $1,318.26 | Professional | 52 · Reduced service | $91.20 | $144.54 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $57.54 Typical High $524.81 | Professional | 53 · Discontinued | $36.31 | $57.54 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $1,995.26 | Professional | 54 · Surgery only | $138.04 | $213.80 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $398.11 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $28.84 Typical High $263.03 | Professional | 56 · Pre-op care only | $18.20 | $28.84 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $1,862.09 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $186.21 Median $295.12 Typical High $446.68 | Professional | 51 · Multiple procedures | $186.21 | $295.12 | $446.68 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $467.74 Typical High $724.44 | Professional | 54 · Surgery only | $302.00 | $467.74 | $724.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $177.83 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $177.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $501.19 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $316.23 | $501.19 | $758.58 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $95.50 Typical High $144.54 | Professional | 80 · Assistant surgeon | $60.26 | $95.50 | $144.54 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $95.50 Typical High $144.54 | Professional | 81 · Minimal assistant surgeon | $60.26 | $95.50 | $144.54 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $95.50 Typical High $144.54 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $95.50 | $144.54 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $83.18 Typical High $125.89 | Professional | AS · PA/NP assist | $52.48 | $83.18 | $125.89 |
Where Wisconsin sits
The same service costs 4.1 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
$832
AK $933KY $229
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.