How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,175 to $18,621Professionalmedian $1,413 · 10th to 90th $562 to $4,266
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 $562.34 Median $6,456.54 Typical High $14,454.40 | Facility | None | $562.34 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $5,623.41 | Professional | None | $562.34 | $562.34 | $5,623.41 |
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 $549.54 Median $2,041.74 Typical High $4,365.16 | Professional | None | $549.54 | $2,041.74 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $3,019.95 Typical High $6,456.54 | Professional | 50 · Both sides | $812.83 | $3,019.95 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $323.59 Typical High $691.83 | Professional | 80 · Assistant surgeon | $87.10 | $323.59 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $288.40 Typical High $602.56 | Professional | AS · PA/NP assist | $75.86 | $288.40 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $11,748.98 | Facility | None | $954.99 | $2,570.40 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,691.53 | Professional | None | $933.25 | $1,023.29 | $2,691.53 |
DeanCare Setting Facility Modifier None Typical Low $676.08 Median $4,365.16 Typical High $7,762.47 | Facility | None | $676.08 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,698.24 | Professional | None | $891.25 | $1,230.27 | $1,698.24 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $1,348.96 | $1,862.09 | $2,570.40 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $144.54 | $199.53 | $275.42 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $125.89 | $173.78 | $239.88 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $7,943.28 Typical High $17,378.01 | Facility | None | $977.24 | $7,943.28 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,479.11 Typical High $4,265.80 | Professional | None | $602.56 | $1,479.11 | $4,265.80 |
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 $707.95 Median $1,318.26 Typical High $1,737.80 | Professional | None | $707.95 | $1,318.26 | $1,737.80 |
Prevea360 Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,148.15 | Facility | None | $562.34 | $758.58 | $1,148.15 |
Quartz Setting Professional Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,454.71 | Professional | None | $602.56 | $1,412.54 | $2,454.71 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $7,762.47 Typical High $12,882.50 | Facility | None | $758.58 | $7,762.47 | $12,882.50 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
Security Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,818.38 Typical High $3,981.07 | Professional | None | $1,258.93 | $2,818.38 | $3,981.07 |
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 $588.84 Median $1,174.90 Typical High $2,754.23 | Professional | None | $588.84 | $1,174.90 | $2,754.23 |
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 $281.84 Median $281.84 Typical High $2,818.38 | Professional | 52 · Reduced service | $281.84 | $281.84 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $1,122.02 | Professional | 53 · Discontinued | $112.20 | $112.20 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $4,168.69 | Professional | 54 · Surgery only | $426.58 | $426.58 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $831.76 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $562.34 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $3,890.45 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $616.60 Typical High $851.14 | Professional | 51 · Multiple procedures | $446.68 | $616.60 | $851.14 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,000.00 Typical High $1,380.38 | Professional | 54 · Surgery only | $707.95 | $1,000.00 | $1,380.38 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $251.19 Typical High $338.84 | Professional | 55 · Aftercare only | $177.83 | $251.19 | $338.84 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,047.13 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $758.58 | $1,047.13 | $1,445.44 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $144.54 Median $199.53 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $144.54 | $199.53 | $275.42 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $144.54 Median $199.53 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $144.54 | $199.53 | $275.42 |
Where Wisconsin sits
The same service costs 7.8 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
$1,995
AK $2,399TX $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.