How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,072 to $13,804Professionalmedian $1,820 · 10th to 90th $661 to $5,012
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 $660.69 Median $8,317.64 Typical High $14,454.40 | Facility | None | $660.69 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $7,079.46 | Professional | None | $660.69 | $660.69 | $7,079.46 |
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 $645.65 Median $2,570.40 Typical High $5,370.32 | Professional | None | $645.65 | $2,570.40 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $416.87 Typical High $851.14 | Professional | 80 · Assistant surgeon | $102.33 | $416.87 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $363.08 Typical High $741.31 | Professional | AS · PA/NP assist | $89.13 | $363.08 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,019.95 Typical High $7,585.78 | Facility | None | $1,202.26 | $3,019.95 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,202.26 | $3,162.28 |
DeanCare Setting Facility Modifier None Typical Low $741.31 Median $5,128.61 Typical High $9,332.54 | Facility | None | $741.31 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,445.44 | $2,089.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $331.13 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $331.13 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $295.12 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $295.12 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,630.78 Typical High $10,000.00 | Facility | None | $933.25 | $3,630.78 | $10,000.00 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,819.70 Typical High $5,011.87 | Professional | None | $741.31 | $1,819.70 | $5,011.87 |
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 $831.76 Median $1,819.70 Typical High $2,137.96 | Professional | None | $831.76 | $1,819.70 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $1,288.25 | Facility | None | $676.08 | $794.33 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,884.03 | Professional | None | $691.83 | $1,584.89 | $2,884.03 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $5,011.87 Typical High $8,317.64 | Facility | None | $933.25 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,202.26 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,801.89 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,801.89 | $4,786.30 |
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 $691.83 Median $1,412.54 Typical High $3,235.94 | Professional | None | $691.83 | $1,412.54 | $3,235.94 |
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 $331.13 Median $331.13 Typical High $3,467.37 | Professional | 52 · Reduced service | $331.13 | $331.13 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,412.54 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $5,248.07 | Professional | 54 · Surgery only | $501.19 | $501.19 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $1,047.13 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $707.95 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $4,897.79 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $724.44 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $588.84 | $724.44 | $1,047.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,659.59 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,659.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $416.87 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,230.27 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,230.27 | $1,737.80 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $234.42 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $190.55 | $234.42 | $331.13 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $234.42 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $234.42 | $331.13 |
Where Wisconsin sits
The same service costs 8.1 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
$2,344
AK $2,754TX $339
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.