How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,202 to $14,454Professionalmedian $2,239 · 10th to 90th $851 to $6,457
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 $851.14 Median $6,456.54 Typical High $14,454.40 | Facility | None | $851.14 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $8,317.64 | Professional | None | $851.14 | $851.14 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $3,162.28 Typical High $6,456.54 | Professional | None | $870.96 | $3,162.28 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $4,677.35 Typical High $9,549.93 | Professional | 50 · Both sides | $1,288.25 | $4,677.35 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,019.95 Typical High $7,585.78 | Facility | None | $954.99 | $3,019.95 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $4,073.80 | Professional | None | $1,412.54 | $1,548.82 | $4,073.80 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $4,365.16 Typical High $7,762.47 | Facility | None | $954.99 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $2,818.38 Typical High $4,073.80 | Professional | 50 · Both sides | $2,290.87 | $2,818.38 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,023.29 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $2,290.87 Typical High $7,943.28 | Professional | None | $933.25 | $2,290.87 | $7,943.28 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,071.52 | $2,089.30 | $2,630.27 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $954.99 Typical High $1,778.28 | Facility | None | $851.14 | $954.99 | $1,778.28 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $2,041.74 Typical High $3,715.35 | Professional | None | $891.25 | $2,041.74 | $3,715.35 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $8,317.64 | Facility | None | $758.58 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,548.82 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,365.16 Typical High $6,165.95 | Professional | None | $2,691.53 | $4,365.16 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,737.80 Typical High $4,365.16 | Professional | None | $891.25 | $1,737.80 | $4,365.16 |
14 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 Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $4,168.69 | Professional | 52 · Reduced service | $426.58 | $426.58 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $1,698.24 | Professional | 53 · Discontinued | $169.82 | $169.82 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $6,309.57 | Professional | 54 · Surgery only | $645.65 | $645.65 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $1,258.93 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $831.76 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $5,888.44 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $933.25 Typical High $1,348.96 | Professional | 51 · Multiple procedures | $758.58 | $933.25 | $1,348.96 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,513.56 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,230.27 | $1,513.56 | $2,137.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $371.54 Typical High $537.03 | Professional | 55 · Aftercare only | $302.00 | $371.54 | $537.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,584.89 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,584.89 | $2,290.87 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 80 · Assistant surgeon | $245.47 | $302.00 | $436.52 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $245.47 | $302.00 | $436.52 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $302.00 | $436.52 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | AS · PA/NP assist | $213.80 | $263.03 | $380.19 |
Where Wisconsin sits
The same service costs 20.9 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
$3,020
AK $3,467TX $166
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.