How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,622 to $13,804Professionalmedian $4,898 · 10th to 90th $2,138 to $13,183
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 $1,737.80 Median $1,737.80 Typical High $2,137.96 | Facility | None | $1,737.80 | $1,737.80 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $20,417.38 | Professional | None | $1,737.80 | $2,137.96 | $20,417.38 |
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 $2,238.72 Median $6,606.93 Typical High $14,125.38 | Professional | None | $2,238.72 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,311.31 Median $10,000.00 Typical High $20,892.96 | Professional | 50 · Both sides | $3,311.31 | $10,000.00 | $20,892.96 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,454.71 Typical High $6,606.93 | Facility | None | $1,023.29 | $2,454.71 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,890.45 Typical High $8,709.64 | Professional | None | $2,884.03 | $3,890.45 | $8,709.64 |
DeanCare Setting Facility Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $5,128.61 | Facility | None | $1,949.84 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $6,456.54 | Professional | None | $3,235.94 | $4,365.16 | $6,456.54 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $6,456.54 Typical High $9,549.93 | Professional | 50 · Both sides | $4,897.79 | $6,456.54 | $9,549.93 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $5,754.40 Typical High $12,882.50 | Facility | None | $1,412.54 | $5,754.40 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $2,630.27 Median $8,912.51 Typical High $15,848.93 | Professional | None | $2,630.27 | $8,912.51 | $15,848.93 |
Network Health Setting Facility Modifier None Typical Low $4,073.80 Median $9,332.54 Typical High $15,848.93 | Facility | None | $4,073.80 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $2,691.53 Median $5,623.41 Typical High $7,079.46 | Professional | None | $2,691.53 | $5,623.41 | $7,079.46 |
Prevea360 Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $4,365.16 | Facility | None | $1,698.24 | $2,398.83 | $4,365.16 |
Quartz Setting Professional Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $9,120.11 | Professional | None | $2,754.23 | $5,128.61 | $9,120.11 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $812.83 | $1,778.28 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $4,677.35 | Professional | None | $3,162.28 | $3,890.45 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,918.31 | Professional | None | $5,754.40 | $5,754.40 | $6,918.31 |
Security Health Setting Professional Modifier None Typical Low $7,585.78 Median $11,220.18 Typical High $13,489.63 | Professional | None | $7,585.78 | $11,220.18 | $13,489.63 |
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 $2,187.76 Median $4,365.16 Typical High $10,471.29 | Professional | None | $2,187.76 | $4,365.16 | $10,471.29 |
18 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 $870.96 Median $870.96 Typical High $1,071.52 | Facility | 52 · Reduced service | $870.96 | $870.96 | $1,071.52 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $426.58 | Facility | 53 · Discontinued | $346.74 | $346.74 | $426.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $316.23 | Facility | 55 · Aftercare only | $257.04 | $257.04 | $316.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $213.80 | Facility | 56 · Pre-op care only | $173.78 | $173.78 | $213.80 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,479.11 | Facility | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,479.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $1,071.52 Typical High $10,232.93 | Professional | 52 · Reduced service | $870.96 | $1,071.52 | $10,232.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $426.58 Typical High $4,073.80 | Professional | 53 · Discontinued | $346.74 | $426.58 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $316.23 Typical High $3,090.30 | Professional | 55 · Aftercare only | $257.04 | $316.23 | $3,090.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $213.80 Typical High $2,041.74 | Professional | 56 · Pre-op care only | $173.78 | $213.80 | $2,041.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,479.11 Typical High $14,454.40 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,479.11 | $14,454.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,621.81 Median $2,187.76 Typical High $3,162.28 | Professional | 51 · Multiple procedures | $1,621.81 | $2,187.76 | $3,162.28 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $3,467.37 Typical High $5,128.61 | Professional | 54 · Surgery only | $2,570.40 | $3,467.37 | $5,128.61 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $870.96 Typical High $1,288.25 | Professional | 55 · Aftercare only | $645.65 | $870.96 | $1,288.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,630.78 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,630.78 | $5,370.32 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $524.81 | $691.83 | $1,023.29 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | 81 · Minimal assistant surgeon | $524.81 | $691.83 | $1,023.29 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | 82 · Assistant surgeon, no resident | $524.81 | $691.83 | $1,023.29 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $602.56 Typical High $891.25 | Professional | AS · PA/NP assist | $457.09 | $602.56 | $891.25 |
Where Wisconsin sits
The same service costs 5.5 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
$5,012
AK $6,918TX $1,259
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.