How much rates vary
Facilitymedian $2,754 · 10th to 90th $603 to $5,888Professionalmedian $1,000 · 10th to 90th $427 to $2,455
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 $323.59 Median $501.19 Typical High $14,454.40 | Facility | None | $323.59 | $501.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $3,715.35 | Professional | None | $323.59 | $501.19 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $1,202.26 Typical High $2,398.83 | Professional | None | $446.68 | $1,202.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $1,737.80 Typical High $3,548.13 | Professional | 50 · Both sides | $676.08 | $1,737.80 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $186.21 Typical High $380.19 | Professional | 80 · Assistant surgeon | $70.79 | $186.21 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $169.82 Typical High $338.84 | Professional | AS · PA/NP assist | $63.10 | $169.82 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,041.74 | Facility | None | $870.96 | $1,380.38 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $2,089.30 | Professional | None | $562.34 | $912.01 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $389.05 Median $4,168.69 Typical High $7,413.10 | Facility | None | $389.05 | $4,168.69 | $7,413.10 |
DeanCare Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,348.96 | Professional | None | $616.60 | $912.01 | $1,348.96 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,380.38 Typical High $1,995.26 | Professional | 50 · Both sides | $933.25 | $1,380.38 | $1,995.26 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $147.91 Typical High $213.80 | Professional | 80 · Assistant surgeon | $97.72 | $147.91 | $213.80 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $128.82 Typical High $186.21 | Professional | AS · PA/NP assist | $87.10 | $128.82 | $186.21 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $4,786.30 | Facility | None | $588.84 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $2,041.74 Typical High $3,801.89 | Professional | None | $524.81 | $2,041.74 | $3,801.89 |
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 $630.96 Median $954.99 Typical High $1,412.54 | Professional | None | $630.96 | $954.99 | $1,412.54 |
Prevea360 Setting Facility Modifier None Typical Low $302.00 Median $524.81 Typical High $933.25 | Facility | None | $302.00 | $524.81 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $2,089.30 | Professional | None | $616.60 | $1,258.93 | $2,089.30 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,041.74 | Facility | None | $758.58 | $1,230.27 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,096.48 | Professional | None | $588.84 | $812.83 | $1,096.48 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,047.13 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,258.93 | $2,089.30 | $3,311.31 |
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 $363.08 Median $776.25 Typical High $2,187.76 | Professional | None | $363.08 | $776.25 | $2,187.76 |
18 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 $162.18 Median $162.18 Typical High $251.19 | Facility | 52 · Reduced service | $162.18 | $162.18 | $251.19 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $100.00 | Facility | 53 · Discontinued | $66.07 | $66.07 | $100.00 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $371.54 | Facility | 54 · Surgery only | $245.47 | $245.47 | $371.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $75.86 | Facility | 55 · Aftercare only | $48.98 | $48.98 | $75.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $50.12 | Facility | 56 · Pre-op care only | $32.36 | $32.36 | $50.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $346.74 | Facility | 78 · Unplanned return to OR | $229.09 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $251.19 Typical High $1,862.09 | Professional | 52 · Reduced service | $162.18 | $251.19 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $100.00 Typical High $758.58 | Professional | 53 · Discontinued | $66.07 | $100.00 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $371.54 Typical High $2,818.38 | Professional | 54 · Surgery only | $245.47 | $371.54 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $75.86 Typical High $562.34 | Professional | 55 · Aftercare only | $48.98 | $75.86 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $50.12 Typical High $371.54 | Professional | 56 · Pre-op care only | $32.36 | $50.12 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $346.74 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $229.09 | $346.74 | $2,630.27 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $457.09 Typical High $676.08 | Professional | 51 · Multiple procedures | $309.03 | $457.09 | $676.08 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $741.31 Typical High $1,071.52 | Professional | 54 · Surgery only | $489.78 | $741.31 | $1,071.52 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $181.97 Typical High $269.15 | Professional | 55 · Aftercare only | $123.03 | $181.97 | $269.15 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $776.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $512.86 | $776.25 | $1,122.02 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $147.91 Typical High $213.80 | Professional | 81 · Minimal assistant surgeon | $97.72 | $147.91 | $213.80 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $97.72 Median $147.91 Typical High $213.80 | Professional | 82 · Assistant surgeon, no resident | $97.72 | $147.91 | $213.80 |
Where Wisconsin sits
The same service costs 5.1 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
$1,148
AK $1,585TX $309
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.