How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,230 to $18,621Professionalmedian $2,138 · 10th to 90th $832 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 $6,456.54 Typical High $14,454.40 | Facility | None | $831.76 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $8,317.64 | Professional | None | $831.76 | $831.76 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $14,454.40 Typical High $22,387.21 | Facility | None | $9,772.37 | $14,454.40 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $3,019.95 Typical High $6,309.57 | Professional | None | $812.83 | $3,019.95 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $4,570.88 Typical High $9,549.93 | Professional | 50 · Both sides | $1,230.27 | $4,570.88 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $478.63 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $131.83 | $478.63 | $1,023.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $426.58 Typical High $891.25 | Professional | AS · PA/NP assist | $114.82 | $426.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,951.21 Typical High $9,332.54 | Facility | None | $954.99 | $2,951.21 | $9,332.54 |
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 $4,365.16 Typical High $7,762.47 | Facility | None | $933.25 | $4,365.16 | $7,762.47 |
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 50 · Both sides Typical Low $2,238.72 Median $2,754.23 Typical High $3,981.07 | Professional | 50 · Both sides | $2,238.72 | $2,754.23 | $3,981.07 |
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 $1,148.15 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,148.15 | $7,943.28 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $2,238.72 Typical High $6,309.57 | Professional | None | $891.25 | $2,238.72 | $6,309.57 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,047.13 | $2,089.30 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $1,737.80 | Facility | None | $831.76 | $933.25 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $2,041.74 Typical High $3,630.78 | Professional | None | $891.25 | $2,041.74 | $3,630.78 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,232.93 | Facility | None | $758.58 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,513.56 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $1,096.48 Median $4,265.80 Typical High $6,025.60 | Professional | None | $1,096.48 | $4,265.80 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,737.80 Typical High $4,168.69 | Professional | None | $870.96 | $1,737.80 | $4,168.69 |
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 $4,168.69 | Professional | 52 · Reduced service | $416.87 | $416.87 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,659.59 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $6,309.57 | Professional | 54 · Surgery only | $630.96 | $630.96 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $1,258.93 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $831.76 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $5,888.44 |
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 $2,089.30 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $2,089.30 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $363.08 Typical High $524.81 | Professional | 55 · Aftercare only | $295.12 | $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 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
$3,020
AK $3,548TX $437
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.