How much rates vary
Facilitymedian $1,259 · 10th to 90th $288 to $3,802Professionalmedian $891 · 10th to 90th $380 to $2,630
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 $371.54 Median $407.38 Typical High $14,454.40 | Facility | None | $371.54 | $407.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $3,388.44 | Professional | None | $371.54 | $407.38 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,318.26 Typical High $2,630.27 | Professional | None | $371.54 | $1,318.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $1,949.84 Typical High $3,981.07 | Professional | 50 · Both sides | $562.34 | $1,949.84 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $1,479.11 | Facility | None | $229.09 | $630.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,737.80 | Professional | None | $588.84 | $741.31 | $1,737.80 |
DeanCare Setting Facility Modifier None Typical Low $398.11 Median $2,570.40 Typical High $4,786.30 | Facility | None | $398.11 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,174.90 | Professional | None | $691.83 | $851.14 | $1,174.90 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $1,047.13 | $1,288.25 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $912.01 Typical High $2,089.30 | Facility | None | $257.04 | $912.01 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,548.82 Typical High $3,019.95 | Professional | None | $407.38 | $1,548.82 | $3,019.95 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,148.15 | Professional | None | $512.86 | $891.25 | $1,148.15 |
Prevea360 Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $758.58 | Facility | None | $338.84 | $457.09 | $758.58 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,621.81 | Professional | None | $616.60 | $1,071.52 | $1,621.81 |
Quartz Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $1,071.52 | Facility | None | $223.87 | $338.84 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $870.96 | Professional | None | $676.08 | $741.31 | $870.96 |
Security Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,174.90 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,995.26 | $2,630.27 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $371.54 Median $794.33 Typical High $1,819.70 | Professional | None | $371.54 | $794.33 | $1,819.70 |
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 $186.21 Median $186.21 Typical High $204.17 | Facility | 52 · Reduced service | $186.21 | $186.21 | $204.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $81.28 | Facility | 53 · Discontinued | $74.13 | $74.13 | $81.28 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $302.00 | Facility | 54 · Surgery only | $275.42 | $275.42 | $302.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $60.26 | Facility | 55 · Aftercare only | $54.95 | $54.95 | $60.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $40.74 | Facility | 56 · Pre-op care only | $37.15 | $37.15 | $40.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $281.84 | Facility | 78 · Unplanned return to OR | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $204.17 Typical High $1,698.24 | Professional | 52 · Reduced service | $186.21 | $204.17 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $676.08 | Professional | 53 · Discontinued | $74.13 | $81.28 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $2,570.40 | Professional | 54 · Surgery only | $275.42 | $302.00 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $512.86 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $338.84 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $2,398.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $426.58 Typical High $575.44 | Professional | 51 · Multiple procedures | $346.74 | $426.58 | $575.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $933.25 | Professional | 54 · Surgery only | $549.54 | $676.08 | $933.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $234.42 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $234.42 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $707.95 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $588.84 | $707.95 | $977.24 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $186.21 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $112.20 | $134.90 | $186.21 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $112.20 | $134.90 | $186.21 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $120.23 Typical High $162.18 | Professional | AS · PA/NP assist | $97.72 | $120.23 | $162.18 |
Where Wisconsin sits
The same service costs 5.2 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
$933
AK $1,514TX $288
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.