How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,479 to $14,791Professionalmedian $2,239 · 10th to 90th $851 to $6,310
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 $831.76 Median $11,220.18 Typical High $14,454.40 | Facility | None | $831.76 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $7,943.28 | Professional | None | $831.76 | $831.76 | $7,943.28 |
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 $851.14 Median $3,162.28 Typical High $6,760.83 | Professional | None | $851.14 | $3,162.28 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $512.86 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $134.90 | $512.86 | $1,071.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $446.68 Typical High $954.99 | Professional | AS · PA/NP assist | $120.23 | $446.68 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $3,801.89 Typical High $12,589.25 | Facility | None | $1,862.09 | $3,801.89 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,513.56 | $3,981.07 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $7,762.47 Typical High $14,125.38 | Facility | None | $933.25 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,819.70 | $2,630.27 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 80 · Assistant surgeon | $239.88 | $295.12 | $426.58 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $257.04 Typical High $371.54 | Professional | AS · PA/NP assist | $208.93 | $257.04 | $371.54 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,000.00 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $2,344.23 Typical High $13,182.57 | Professional | None | $933.25 | $2,344.23 | $13,182.57 |
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 $1,047.13 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,995.26 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $933.25 Typical High $1,737.80 | Facility | None | $851.14 | $933.25 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $3,630.78 | Professional | None | $851.14 | $1,949.84 | $3,630.78 |
Quartz Setting Facility Modifier None Typical Low $1,479.11 Median $8,317.64 Typical High $13,803.84 | Facility | None | $1,479.11 | $8,317.64 | $13,803.84 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,513.56 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $6,025.60 | Professional | None | $2,818.38 | $4,168.69 | $6,025.60 |
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 $870.96 Median $1,778.28 Typical High $4,265.80 | Professional | None | $870.96 | $1,778.28 | $4,265.80 |
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 $416.87 Median $416.87 Typical High $3,981.07 | Professional | 52 · Reduced service | $416.87 | $416.87 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,621.81 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $6,025.60 | Professional | 54 · Surgery only | $630.96 | $630.96 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $1,202.26 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $794.33 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $5,623.41 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $741.31 | $912.01 | $1,318.26 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $2,137.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $363.08 Typical High $524.81 | Professional | 55 · Aftercare only | $302.00 | $363.08 | $524.81 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $239.88 | $295.12 | $426.58 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $295.12 | $426.58 |
Where Wisconsin sits
The same service costs 17.8 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
$3,020
AK $3,388TX $191
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.