How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $5,754Professionalmedian $1,549 · 10th to 90th $661 to $4,365
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 $588.84 Median $707.95 Typical High $14,454.40 | Facility | None | $588.84 | $707.95 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $6,918.31 | Professional | None | $588.84 | $707.95 | $6,918.31 |
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 $660.69 Median $2,187.76 Typical High $4,570.88 | Professional | None | $660.69 | $2,187.76 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,238.72 | Facility | None | $891.25 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,951.21 | Professional | None | $954.99 | $1,258.93 | $2,951.21 |
DeanCare Setting Facility Modifier None Typical Low $588.84 Median $3,090.30 Typical High $5,370.32 | Facility | None | $588.84 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,445.44 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $4,786.30 | Facility | None | $630.96 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $2,754.23 Typical High $5,248.07 | Professional | None | $707.95 | $2,754.23 | $5,248.07 |
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 $891.25 Median $1,737.80 Typical High $2,187.76 | Professional | None | $891.25 | $1,737.80 | $2,187.76 |
Prevea360 Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $1,230.27 | Facility | None | $549.54 | $691.83 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,754.23 | Professional | None | $954.99 | $1,737.80 | $2,754.23 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $1,230.27 Typical High $2,041.74 | Facility | None | $724.44 | $1,230.27 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,258.93 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $4,677.35 | Professional | None | $1,995.26 | $3,801.89 | $4,677.35 |
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 $630.96 Median $1,318.26 Typical High $3,235.94 | Professional | None | $630.96 | $1,318.26 | $3,235.94 |
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 $295.12 Median $295.12 Typical High $354.81 | Facility | 52 · Reduced service | $295.12 | $295.12 | $354.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $141.25 | Facility | 53 · Discontinued | $117.49 | $117.49 | $141.25 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $524.81 | Facility | 54 · Surgery only | $436.52 | $436.52 | $524.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $104.71 | Facility | 55 · Aftercare only | $87.10 | $87.10 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $70.79 | Facility | 56 · Pre-op care only | $58.88 | $58.88 | $70.79 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $354.81 Typical High $3,388.44 | Professional | 52 · Reduced service | $295.12 | $354.81 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $1,380.38 | Professional | 53 · Discontinued | $117.49 | $141.25 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $5,128.61 | Professional | 54 · Surgery only | $436.52 | $524.81 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $104.71 Typical High $1,023.29 | Professional | 55 · Aftercare only | $87.10 | $104.71 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $691.83 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $4,786.30 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $549.54 Median $724.44 Typical High $954.99 | Professional | 51 · Multiple procedures | $549.54 | $724.44 | $954.99 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,148.15 Typical High $1,513.56 | Professional | 54 · Surgery only | $870.96 | $1,148.15 | $1,513.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | 55 · Aftercare only | $218.78 | $288.40 | $380.19 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,202.26 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $933.25 | $1,202.26 | $1,584.89 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $229.09 Typical High $302.00 | Professional | 80 · Assistant surgeon | $177.83 | $229.09 | $302.00 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $229.09 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $177.83 | $229.09 | $302.00 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $229.09 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $177.83 | $229.09 | $302.00 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $154.88 | $199.53 | $269.15 |
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
$1,738
AK $2,399TX $427
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.