How much rates vary
Facilitymedian $1,445 · 10th to 90th $302 to $4,074Professionalmedian $1,122 · 10th to 90th $417 to $2,089
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 $407.38 Typical High $14,454.40 | Facility | None | $309.03 | $407.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $2,691.53 | Professional | None | $309.03 | $407.38 | $2,691.53 |
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 $537.03 Median $1,348.96 Typical High $2,137.96 | Professional | None | $537.03 | $1,348.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,288.25 Typical High $1,949.84 | Facility | None | $50.12 | $1,288.25 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $1,445.44 | Professional | None | $416.87 | $616.60 | $1,445.44 |
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 $851.14 Typical High $1,288.25 | Professional | None | $630.96 | $851.14 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $954.99 Typical High $1,778.28 | Facility | None | $218.78 | $954.99 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,584.89 Typical High $3,548.13 | Professional | None | $489.78 | $1,584.89 | $3,548.13 |
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 $660.69 Median $1,071.52 Typical High $1,380.38 | Professional | None | $660.69 | $1,071.52 | $1,380.38 |
Prevea360 Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $954.99 | Facility | None | $331.13 | $436.52 | $954.99 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $1,548.82 | Professional | None | $549.54 | $1,047.13 | $1,548.82 |
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 $416.87 Median $549.54 Typical High $870.96 | Professional | None | $416.87 | $549.54 | $870.96 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | None | $660.69 | $660.69 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $794.33 Median $1,698.24 Typical High $2,290.87 | Professional | None | $794.33 | $1,698.24 | $2,290.87 |
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 $398.11 Median $954.99 Typical High $1,905.46 | Professional | None | $398.11 | $954.99 | $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 $204.17 | Facility | 52 · Reduced service | $154.88 | $154.88 | $204.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $81.28 | Facility | 53 · Discontinued | $61.66 | $61.66 | $81.28 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $309.03 | Facility | 54 · Surgery only | $234.42 | $234.42 | $309.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $61.66 | Facility | 55 · Aftercare only | $46.77 | $46.77 | $61.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $40.74 | Facility | 56 · Pre-op care only | $30.90 | $30.90 | $40.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $288.40 | Facility | 78 · Unplanned return to OR | $218.78 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $204.17 Typical High $1,348.96 | Professional | 52 · Reduced service | $154.88 | $204.17 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $81.28 Typical High $537.03 | Professional | 53 · Discontinued | $61.66 | $81.28 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $309.03 Typical High $1,995.26 | Professional | 54 · Surgery only | $234.42 | $309.03 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $61.66 Typical High $398.11 | Professional | 55 · Aftercare only | $46.77 | $61.66 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $40.74 Typical High $269.15 | Professional | 56 · Pre-op care only | $30.90 | $40.74 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $288.40 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $218.78 | $288.40 | $1,862.09 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $416.87 Typical High $645.65 | Professional | 51 · Multiple procedures | $316.23 | $416.87 | $645.65 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $676.08 Typical High $1,023.29 | Professional | 54 · Surgery only | $512.86 | $676.08 | $1,023.29 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $169.82 Typical High $257.04 | Professional | 55 · Aftercare only | $125.89 | $169.82 | $257.04 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $707.95 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $537.03 | $707.95 | $1,071.52 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $134.90 Typical High $204.17 | Professional | 80 · Assistant surgeon | $102.33 | $134.90 | $204.17 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $134.90 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $102.33 | $134.90 | $204.17 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $134.90 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $134.90 | $204.17 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $117.49 Typical High $177.83 | Professional | AS · PA/NP assist | $89.13 | $117.49 | $177.83 |
Where Wisconsin sits
The same service costs 4.7 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
$1,175
AK $1,445TX $309
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.