How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,288 to $13,804Professionalmedian $3,631 · 10th to 90th $1,585 to $9,550
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 $1,288.25 Median $1,288.25 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,288.25 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $15,488.17 | Professional | None | $1,288.25 | $1,584.89 | $15,488.17 |
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 $1,584.89 Median $4,897.79 Typical High $10,964.78 | Professional | None | $1,584.89 | $4,897.79 | $10,964.78 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $4,897.79 | Facility | None | $954.99 | $1,819.70 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,884.03 Typical High $6,456.54 | Professional | None | $2,137.96 | $2,884.03 | $6,456.54 |
DeanCare Setting Facility Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $5,128.61 | Facility | None | $1,479.11 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $4,786.30 | Professional | None | $2,398.83 | $3,235.94 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $5,754.40 Typical High $12,882.50 | Facility | None | $1,230.27 | $5,754.40 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $6,606.93 Typical High $11,748.98 | Professional | None | $1,949.84 | $6,606.93 | $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 $4,168.69 Typical High $5,248.07 | Professional | None | $1,995.26 | $4,168.69 | $5,248.07 |
Prevea360 Setting Facility Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,235.94 | Facility | None | $1,258.93 | $1,778.28 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $6,760.83 | Professional | None | $2,041.74 | $3,801.89 | $6,760.83 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $2,238.72 | Facility | None | $812.83 | $1,348.96 | $2,238.72 |
Quartz Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,290.87 | $2,884.03 | $3,467.37 |
Security Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,128.61 | Professional | None | $4,168.69 | $4,168.69 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $5,623.41 Median $8,128.31 Typical High $10,232.93 | Professional | None | $5,623.41 | $8,128.31 | $10,232.93 |
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 $1,621.81 Median $3,162.28 Typical High $7,943.28 | Professional | None | $1,621.81 | $3,162.28 | $7,943.28 |
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 $645.65 Median $645.65 Typical High $794.33 | Facility | 52 · Reduced service | $645.65 | $645.65 | $794.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $316.23 | Facility | 53 · Discontinued | $257.04 | $257.04 | $316.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $234.42 | Facility | 55 · Aftercare only | $190.55 | $190.55 | $234.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $158.49 | Facility | 56 · Pre-op care only | $128.82 | $128.82 | $158.49 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Facility | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $794.33 Typical High $7,762.47 | Professional | 52 · Reduced service | $645.65 | $794.33 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $3,090.30 | Professional | 53 · Discontinued | $257.04 | $316.23 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $2,290.87 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $10,715.19 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,202.26 Median $1,621.81 Typical High $2,398.83 | Professional | 51 · Multiple procedures | $1,202.26 | $1,621.81 | $2,398.83 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,570.40 Typical High $3,801.89 | Professional | 54 · Surgery only | $1,905.46 | $2,570.40 | $3,801.89 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $645.65 Typical High $954.99 | Professional | 55 · Aftercare only | $478.63 | $645.65 | $954.99 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,691.53 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,691.53 | $3,981.07 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $512.86 Typical High $758.58 | Professional | 80 · Assistant surgeon | $380.19 | $512.86 | $758.58 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $512.86 Typical High $758.58 | Professional | 81 · Minimal assistant surgeon | $380.19 | $512.86 | $758.58 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $512.86 Typical High $758.58 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $512.86 | $758.58 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $446.68 Typical High $660.69 | Professional | AS · PA/NP assist | $338.84 | $446.68 | $660.69 |
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
$3,802
AK $5,129TX $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.