How much rates vary
Facilitymedian $1,514 · 10th to 90th $282 to $3,802Professionalmedian $1,445 · 10th to 90th $661 to $3,631
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 $478.63 Median $676.08 Typical High $14,454.40 | Facility | None | $478.63 | $676.08 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $2,630.27 | Professional | None | $478.63 | $676.08 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,862.09 Typical High $4,073.80 | Professional | None | $630.96 | $1,862.09 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $812.83 Typical High $2,454.71 | Facility | None | $218.78 | $812.83 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $2,818.38 | Professional | None | $812.83 | $1,230.27 | $2,818.38 |
DeanCare Setting Facility Modifier None Typical Low $575.44 Median $2,630.27 Typical High $5,128.61 | Facility | None | $575.44 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,862.09 | Professional | None | $912.01 | $1,288.25 | $1,862.09 |
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 $794.33 Median $2,884.03 Typical High $5,128.61 | Professional | None | $794.33 | $2,884.03 | $5,128.61 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $2,137.96 | Professional | None | $851.14 | $1,584.89 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $478.63 Median $758.58 Typical High $1,412.54 | Facility | None | $478.63 | $758.58 | $1,412.54 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,621.81 Typical High $2,951.21 | Professional | None | $794.33 | $1,621.81 | $2,951.21 |
Quartz Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $1,479.11 | Facility | None | $213.80 | $323.59 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,479.11 | Professional | None | $870.96 | $1,230.27 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,584.89 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,187.76 | $3,090.30 | $4,365.16 |
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 $645.65 Median $1,174.90 Typical High $3,311.31 | Professional | None | $645.65 | $1,174.90 | $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 $239.88 Median $239.88 Typical High $338.84 | Facility | 52 · Reduced service | $239.88 | $239.88 | $338.84 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $134.90 | Facility | 53 · Discontinued | $95.50 | $95.50 | $134.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $512.86 | Facility | 54 · Surgery only | $363.08 | $363.08 | $512.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $102.33 | Facility | 55 · Aftercare only | $72.44 | $72.44 | $102.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $67.61 | Facility | 56 · Pre-op care only | $47.86 | $47.86 | $67.61 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $478.63 | Facility | 78 · Unplanned return to OR | $338.84 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $338.84 Typical High $1,318.26 | Professional | 52 · Reduced service | $239.88 | $338.84 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $134.90 Typical High $537.03 | Professional | 53 · Discontinued | $95.50 | $134.90 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $512.86 Typical High $1,995.26 | Professional | 54 · Surgery only | $363.08 | $512.86 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $102.33 Typical High $398.11 | Professional | 55 · Aftercare only | $72.44 | $102.33 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $67.61 Typical High $263.03 | Professional | 56 · Pre-op care only | $47.86 | $67.61 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $478.63 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $338.84 | $478.63 | $1,862.09 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $645.65 Typical High $933.25 | Professional | 51 · Multiple procedures | $446.68 | $645.65 | $933.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,023.29 Typical High $1,479.11 | Professional | 54 · Surgery only | $724.44 | $1,023.29 | $1,479.11 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $257.04 Typical High $371.54 | Professional | 55 · Aftercare only | $181.97 | $257.04 | $371.54 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,071.52 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $758.58 | $1,071.52 | $1,548.82 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $204.17 Typical High $295.12 | Professional | 80 · Assistant surgeon | $144.54 | $204.17 | $295.12 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $204.17 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $144.54 | $204.17 | $295.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $204.17 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $204.17 | $295.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $125.89 | $181.97 | $257.04 |
Where Wisconsin sits
The same service costs 3.6 times more in Alaska than in Maryland. 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
$1,479
AK $1,950MD $537
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.