How much rates vary
Facilitymedian $6,918 · 10th to 90th $776 to $14,454Professionalmedian $1,175 · 10th to 90th $490 to $3,162
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 $363.08 Median $616.60 Typical High $14,454.40 | Facility | None | $363.08 | $616.60 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $7,585.78 | Professional | None | $363.08 | $616.60 | $7,585.78 |
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 $489.78 Median $1,412.54 Typical High $3,162.28 | Professional | None | $489.78 | $1,412.54 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $7,585.78 | Facility | None | $1,000.00 | $2,238.72 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $2,570.40 | Professional | None | $660.69 | $1,122.02 | $2,570.40 |
DeanCare Setting Facility Modifier None Typical Low $407.38 Median $3,090.30 Typical High $5,370.32 | Facility | None | $407.38 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,659.59 | Professional | None | $676.08 | $1,096.48 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $5,754.40 Typical High $15,848.93 | Facility | None | $776.25 | $5,754.40 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $2,630.27 Typical High $4,570.88 | Professional | None | $707.95 | $2,630.27 | $4,570.88 |
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 $776.25 Median $1,230.27 Typical High $1,905.46 | Professional | None | $776.25 | $1,230.27 | $1,905.46 |
Prevea360 Setting Facility Modifier None Typical Low $323.59 Median $616.60 Typical High $977.24 | Facility | None | $323.59 | $616.60 | $977.24 |
Quartz Setting Professional Modifier None Typical Low $707.95 Median $1,445.44 Typical High $2,691.53 | Professional | None | $707.95 | $1,445.44 | $2,691.53 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $5,011.87 Typical High $8,317.64 | Facility | None | $724.44 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $1,380.38 | Professional | None | $660.69 | $1,122.02 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,174.90 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,318.26 | $2,511.89 | $4,073.80 |
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 $446.68 Median $1,000.00 Typical High $2,884.03 | Professional | None | $446.68 | $1,000.00 | $2,884.03 |
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 $181.97 Median $181.97 Typical High $309.03 | Facility | 52 · Reduced service | $181.97 | $181.97 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $123.03 | Facility | 53 · Discontinued | $72.44 | $72.44 | $123.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $457.09 | Facility | 54 · Surgery only | $269.15 | $269.15 | $457.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $93.33 | Facility | 55 · Aftercare only | $53.70 | $53.70 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $61.66 | Facility | 56 · Pre-op care only | $36.31 | $36.31 | $61.66 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $426.58 | Facility | 78 · Unplanned return to OR | $251.19 | $251.19 | $426.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $309.03 Typical High $3,801.89 | Professional | 52 · Reduced service | $181.97 | $309.03 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $123.03 Typical High $1,513.56 | Professional | 53 · Discontinued | $72.44 | $123.03 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $457.09 Typical High $5,623.41 | Professional | 54 · Surgery only | $269.15 | $457.09 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $93.33 Typical High $1,122.02 | Professional | 55 · Aftercare only | $53.70 | $93.33 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $61.66 Typical High $758.58 | Professional | 56 · Pre-op care only | $36.31 | $61.66 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $426.58 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $251.19 | $426.58 | $5,248.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $338.84 Median $549.54 Typical High $831.76 | Professional | 51 · Multiple procedures | $338.84 | $549.54 | $831.76 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $537.03 | $891.25 | $1,318.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $218.78 Typical High $331.13 | Professional | 55 · Aftercare only | $134.90 | $218.78 | $331.13 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $933.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $575.44 | $933.25 | $1,380.38 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $177.83 Typical High $263.03 | Professional | 80 · Assistant surgeon | $109.65 | $177.83 | $263.03 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $177.83 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $109.65 | $177.83 | $263.03 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $177.83 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $177.83 | $263.03 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $154.88 Typical High $229.09 | Professional | AS · PA/NP assist | $95.50 | $154.88 | $229.09 |
Where Wisconsin sits
The same service costs 4.9 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
$1,413
AK $1,862TX $380
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.