How much rates vary
Facilitymedian $3,090 · 10th to 90th $759 to $8,710Professionalmedian $2,188 · 10th to 90th $813 to $3,802
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 $602.56 Median $741.31 Typical High $14,454.40 | Facility | None | $602.56 | $741.31 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $8,912.51 | Professional | None | $602.56 | $741.31 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $6,760.83 Typical High $11,481.54 | Facility | None | $2,041.74 | $6,760.83 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $3,890.45 | Professional | None | $1,047.13 | $2,511.89 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $3,630.78 | Facility | None | $1,023.29 | $2,454.71 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,570.40 | Professional | None | $794.33 | $1,174.90 | $2,570.40 |
DeanCare Setting Facility Modifier None Typical Low $776.25 Median $3,090.30 Typical High $5,370.32 | Facility | None | $776.25 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,513.56 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $6,165.95 | Facility | None | $630.96 | $2,187.76 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $2,754.23 Typical High $6,456.54 | Professional | None | $891.25 | $2,754.23 | $6,456.54 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,905.46 | $2,398.83 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $1,445.44 | Facility | None | $575.44 | $851.14 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,148.15 | $2,089.30 | $3,090.30 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,630.78 | Facility | None | $812.83 | $2,290.87 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,737.80 | Professional | None | $741.31 | $977.24 | $1,737.80 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $1,548.82 Median $3,162.28 Typical High $4,168.69 | Professional | None | $1,548.82 | $3,162.28 | $4,168.69 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,778.28 Typical High $3,311.31 | Professional | None | $776.25 | $1,778.28 | $3,311.31 |
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 $302.00 Median $302.00 Typical High $371.54 | Facility | 52 · Reduced service | $302.00 | $302.00 | $371.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $147.91 | Facility | 53 · Discontinued | $120.23 | $120.23 | $147.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $549.54 | Facility | 54 · Surgery only | $457.09 | $457.09 | $549.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $109.65 | Facility | 55 · Aftercare only | $91.20 | $91.20 | $109.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $74.13 | Facility | 56 · Pre-op care only | $60.26 | $60.26 | $74.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $512.86 | Facility | 78 · Unplanned return to OR | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $371.54 Typical High $4,466.84 | Professional | 52 · Reduced service | $302.00 | $371.54 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $147.91 Typical High $1,778.28 | Professional | 53 · Discontinued | $120.23 | $147.91 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $6,606.93 | Professional | 54 · Surgery only | $457.09 | $549.54 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $1,318.26 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $74.13 Typical High $891.25 | Professional | 56 · Pre-op care only | $60.26 | $74.13 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $6,165.95 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $758.58 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $616.60 | $758.58 | $1,148.15 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,202.26 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,000.00 | $1,202.26 | $1,862.09 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $302.00 Typical High $457.09 | Professional | 55 · Aftercare only | $251.19 | $302.00 | $457.09 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,258.93 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,258.93 | $1,949.84 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $371.54 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $371.54 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $239.88 Typical High $371.54 | Professional | 81 · Minimal assistant surgeon | $199.53 | $239.88 | $371.54 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $239.88 Typical High $371.54 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $239.88 | $371.54 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $213.80 Typical High $323.59 | Professional | AS · PA/NP assist | $173.78 | $213.80 | $323.59 |
Where Wisconsin sits
The same service costs 4.9 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
$2,291
AK $2,884TX $589
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.