How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,230 to $13,490Professionalmedian $1,862 · 10th to 90th $724 to $5,370
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 $724.44 Median $11,220.18 Typical High $14,454.40 | Facility | None | $724.44 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $13,489.63 | Professional | None | $724.44 | $724.44 | $13,489.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $16,982.44 | Facility | None | $5,754.40 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $2,570.40 Typical High $5,495.41 | Professional | None | $758.58 | $2,570.40 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $407.38 Typical High $870.96 | Professional | 80 · Assistant surgeon | $120.23 | $407.38 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $354.81 Typical High $758.58 | Professional | AS · PA/NP assist | $104.71 | $354.81 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,311.31 Typical High $7,585.78 | Facility | None | $1,737.80 | $3,311.31 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $3,467.37 | Professional | None | $1,174.90 | $1,318.26 | $3,467.37 |
DeanCare Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $10,232.93 | Facility | None | $851.14 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,584.89 | $2,187.76 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $257.04 Typical High $346.74 | Professional | 80 · Assistant surgeon | $208.93 | $257.04 | $346.74 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $223.87 Typical High $309.03 | Professional | AS · PA/NP assist | $181.97 | $223.87 | $309.03 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,630.78 Typical High $9,549.93 | Facility | None | $933.25 | $3,630.78 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,905.46 Typical High $7,585.78 | Professional | None | $794.33 | $1,905.46 | $7,585.78 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $912.01 Median $1,584.89 Typical High $2,041.74 | Professional | None | $912.01 | $1,584.89 | $2,041.74 |
Prevea360 Setting Facility Modifier None Typical Low $741.31 Median $870.96 Typical High $1,513.56 | Facility | None | $741.31 | $870.96 | $1,513.56 |
Quartz Setting Professional Modifier None Typical Low $776.25 Median $1,778.28 Typical High $3,235.94 | Professional | None | $776.25 | $1,778.28 | $3,235.94 |
Quartz Setting Facility Modifier None Typical Low $1,479.11 Median $5,248.07 Typical High $8,317.64 | Facility | None | $1,479.11 | $5,248.07 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Security Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,548.13 Typical High $5,370.32 | Professional | None | $2,137.96 | $3,548.13 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $3,801.89 | Professional | None | $758.58 | $1,513.56 | $3,801.89 |
12 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 Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $6,606.93 | Professional | 52 · Reduced service | $363.08 | $363.08 | $6,606.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $2,691.53 | Professional | 53 · Discontinued | $144.54 | $144.54 | $2,691.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $10,000.00 | Professional | 54 · Surgery only | $549.54 | $549.54 | $10,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $1,995.26 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $1,995.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $1,348.96 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $1,348.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $9,332.54 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $9,332.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $794.33 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $645.65 | $794.33 | $1,096.48 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,288.25 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,047.13 | $1,288.25 | $1,737.80 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $316.23 Typical High $436.52 | Professional | 55 · Aftercare only | $257.04 | $316.23 | $436.52 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,348.96 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,348.96 | $1,819.70 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $257.04 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $208.93 | $257.04 | $346.74 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $257.04 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $257.04 | $346.74 |
Where Wisconsin sits
The same service costs 17.4 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
$2,512
AK $3,020TX $174
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.