How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,318 to $12,303Professionalmedian $3,388 · 10th to 90th $1,549 to $8,913
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 $1,202.26 Median $1,202.26 Typical High $1,548.82 | Facility | None | $1,202.26 | $1,202.26 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $14,454.40 | Professional | None | $1,202.26 | $1,548.82 | $14,454.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,818.38 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $4,570.88 Typical High $10,232.93 | Professional | None | $1,584.89 | $4,570.88 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,995.26 Typical High $4,897.79 | Facility | None | $1,023.29 | $1,995.26 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $6,456.54 | Professional | None | $1,995.26 | $2,818.38 | $6,456.54 |
DeanCare Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $5,128.61 | Facility | None | $1,412.54 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $4,677.35 | Professional | None | $2,238.72 | $3,090.30 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,495.41 Typical High $12,882.50 | Facility | None | $1,174.90 | $5,495.41 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $6,456.54 Typical High $11,748.98 | Professional | None | $1,905.46 | $6,456.54 | $11,748.98 |
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 $1,995.26 Median $4,073.80 Typical High $5,128.61 | Professional | None | $1,995.26 | $4,073.80 | $5,128.61 |
Prevea360 Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $3,235.94 | Facility | None | $1,174.90 | $1,737.80 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $1,905.46 Median $3,715.35 Typical High $6,760.83 | Professional | None | $1,905.46 | $3,715.35 | $6,760.83 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,454.71 | Facility | None | $812.83 | $1,479.11 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,137.96 | $2,818.38 | $3,388.44 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $5,011.87 | Professional | None | $3,890.45 | $3,890.45 | $5,011.87 |
Security Health Setting Professional Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $10,000.00 | Professional | None | $5,248.07 | $7,585.78 | $10,000.00 |
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 $1,513.56 Median $2,951.21 Typical High $7,585.78 | Professional | None | $1,513.56 | $2,951.21 | $7,585.78 |
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 $602.56 Median $602.56 Typical High $776.25 | Facility | 52 · Reduced service | $602.56 | $602.56 | $776.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $316.23 | Facility | 53 · Discontinued | $239.88 | $239.88 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $234.42 | Facility | 55 · Aftercare only | $177.83 | $177.83 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $154.88 | Facility | 56 · Pre-op care only | $120.23 | $120.23 | $154.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Facility | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,096.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $776.25 Typical High $7,244.36 | Professional | 52 · Reduced service | $602.56 | $776.25 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $316.23 Typical High $2,884.03 | Professional | 53 · Discontinued | $239.88 | $316.23 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $234.42 Typical High $2,187.76 | Professional | 55 · Aftercare only | $177.83 | $234.42 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $154.88 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $120.23 | $154.88 | $1,445.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,096.48 Typical High $10,232.93 | Professional | 78 · Unplanned return to OR | $831.76 | $1,096.48 | $10,232.93 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,548.82 Typical High $2,344.23 | Professional | 51 · Multiple procedures | $1,122.02 | $1,548.82 | $2,344.23 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,511.89 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,778.28 | $2,511.89 | $3,715.35 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $630.96 Typical High $933.25 | Professional | 55 · Aftercare only | $446.68 | $630.96 | $933.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,630.27 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,630.27 | $3,890.45 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $501.19 Typical High $741.31 | Professional | 80 · Assistant surgeon | $354.81 | $501.19 | $741.31 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $501.19 Typical High $741.31 | Professional | 81 · Minimal assistant surgeon | $354.81 | $501.19 | $741.31 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $501.19 Typical High $741.31 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $501.19 | $741.31 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $436.52 Typical High $660.69 | Professional | AS · PA/NP assist | $316.23 | $436.52 | $660.69 |
Where Wisconsin sits
The same service costs 5.1 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
$3,548
AK $4,786TX $933
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.