How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,454Professionalmedian $3,715 · 10th to 90th $1,413 to $10,471
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 $1,412.54 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,412.54 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $15,848.93 | Professional | None | $1,412.54 | $1,412.54 | $15,848.93 |
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 $1,412.54 Median $5,370.32 Typical High $10,715.19 | Professional | None | $1,412.54 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $851.14 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $223.87 | $851.14 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $741.31 Typical High $1,513.56 | Professional | AS · PA/NP assist | $199.53 | $741.31 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,011.87 Typical High $9,549.93 | Facility | None | $1,023.29 | $5,011.87 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $6,606.93 | Professional | None | $2,290.87 | $2,511.89 | $6,606.93 |
DeanCare Setting Facility Modifier None Typical Low $1,584.89 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,584.89 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,090.30 | $4,466.84 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 80 · Assistant surgeon | $398.11 | $489.78 | $707.95 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | AS · PA/NP assist | $346.74 | $426.58 | $616.60 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $15,135.61 | Facility | None | $1,230.27 | $6,606.93 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $3,801.89 Typical High $16,982.44 | Professional | None | $1,548.82 | $3,801.89 | $16,982.44 |
Network Health Setting Facility Modifier None Typical Low $2,754.23 Median $9,332.54 Typical High $15,848.93 | Facility | None | $2,754.23 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $4,365.16 | Professional | None | $1,778.28 | $3,311.31 | $4,365.16 |
Prevea360 Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,951.21 | Facility | None | $1,318.26 | $1,659.59 | $2,951.21 |
Quartz Setting Professional Modifier None Typical Low $1,412.54 Median $3,235.94 Typical High $6,165.95 | Professional | None | $1,412.54 | $3,235.94 | $6,165.95 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $6,456.54 Typical High $10,471.29 | Facility | None | $812.83 | $6,456.54 | $10,471.29 |
Quartz Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,511.89 | $2,511.89 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,786.30 Median $6,918.31 Typical High $10,232.93 | Professional | None | $4,786.30 | $6,918.31 | $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 $1,445.44 Median $2,884.03 Typical High $7,079.46 | Professional | None | $1,445.44 | $2,884.03 | $7,079.46 |
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 $707.95 Median $707.95 Typical High $7,943.28 | Professional | 52 · Reduced service | $707.95 | $707.95 | $7,943.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $3,162.28 | Professional | 53 · Discontinued | $281.84 | $281.84 | $3,162.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $11,748.98 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $11,748.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $2,344.23 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $1,584.89 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $10,964.78 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $10,964.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,258.93 Median $1,548.82 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $1,258.93 | $1,548.82 | $2,187.76 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,454.71 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,995.26 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $616.60 Typical High $891.25 | Professional | 55 · Aftercare only | $501.19 | $616.60 | $891.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,570.40 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,570.40 | $3,715.35 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $398.11 | $489.78 | $707.95 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $489.78 | $707.95 |
Where Wisconsin sits
The same service costs 19.5 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
$4,677
AK $5,754TX $295
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.