How much rates vary
Facilitymedian $3,020 · 10th to 90th $794 to $6,166Professionalmedian $1,698 · 10th to 90th $759 to $4,898
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 $630.96 Median $794.33 Typical High $14,454.40 | Facility | None | $630.96 | $794.33 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $6,456.54 | Professional | None | $630.96 | $794.33 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $2,290.87 Typical High $4,786.30 | Professional | None | $758.58 | $2,290.87 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $2,818.38 | Facility | None | $1,096.48 | $1,905.46 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $3,311.31 | Professional | None | $1,023.29 | $1,445.44 | $3,311.31 |
DeanCare Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $8,912.51 | Facility | None | $758.58 | $4,786.30 | $8,912.51 |
DeanCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,584.89 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,187.76 Typical High $4,786.30 | Facility | None | $707.95 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $3,090.30 Typical High $6,760.83 | Professional | None | $891.25 | $3,090.30 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,862.09 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $630.96 Median $912.01 Typical High $1,318.26 | Facility | None | $630.96 | $912.01 | $1,318.26 |
Quartz Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,000.00 | $1,862.09 | $3,090.30 |
Quartz Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,344.23 | Facility | None | $1,096.48 | $1,445.44 | $2,344.23 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,445.44 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,089.30 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $4,073.80 Typical High $5,128.61 | Professional | None | $2,089.30 | $4,073.80 | $5,128.61 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $3,630.78 | Professional | None | $741.31 | $1,412.54 | $3,630.78 |
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 $316.23 Median $316.23 Typical High $398.11 | Facility | 52 · Reduced service | $316.23 | $316.23 | $398.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $158.49 | Facility | 53 · Discontinued | $125.89 | $125.89 | $158.49 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $588.84 | Facility | 54 · Surgery only | $467.74 | $467.74 | $588.84 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $117.49 | Facility | 55 · Aftercare only | $95.50 | $95.50 | $117.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $79.43 | Facility | 56 · Pre-op care only | $63.10 | $63.10 | $79.43 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $549.54 | Facility | 78 · Unplanned return to OR | $436.52 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $398.11 Typical High $3,235.94 | Professional | 52 · Reduced service | $316.23 | $398.11 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $158.49 Typical High $1,288.25 | Professional | 53 · Discontinued | $125.89 | $158.49 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $4,786.30 | Professional | 54 · Surgery only | $467.74 | $588.84 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $117.49 Typical High $954.99 | Professional | 55 · Aftercare only | $95.50 | $117.49 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $79.43 Typical High $645.65 | Professional | 56 · Pre-op care only | $63.10 | $79.43 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $4,466.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $794.33 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $588.84 | $794.33 | $1,047.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,258.93 Typical High $1,698.24 | Professional | 54 · Surgery only | $954.99 | $1,258.93 | $1,698.24 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $316.23 Typical High $426.58 | Professional | 55 · Aftercare only | $234.42 | $316.23 | $426.58 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $1,778.28 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $257.04 Typical High $338.84 | Professional | 80 · Assistant surgeon | $190.55 | $257.04 | $338.84 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $257.04 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $190.55 | $257.04 | $338.84 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $257.04 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $257.04 | $338.84 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $223.87 Typical High $295.12 | Professional | AS · PA/NP assist | $165.96 | $223.87 | $295.12 |
Where Wisconsin sits
The same service costs 5.6 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
$1,862
AK $2,630TX $468
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.