How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,023 to $18,621Professionalmedian $1,549 · 10th to 90th $617 to $4,571
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 $616.60 Median $8,317.64 Typical High $14,454.40 | Facility | None | $616.60 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $6,025.60 | Professional | None | $616.60 | $616.60 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $14,454.40 Typical High $22,387.21 | Facility | None | $5,888.44 | $14,454.40 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $2,238.72 Typical High $4,677.35 | Professional | None | $588.84 | $2,238.72 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $3,311.31 Typical High $7,079.46 | Professional | 50 · Both sides | $891.25 | $3,311.31 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $354.81 Typical High $741.31 | Professional | 80 · Assistant surgeon | $95.50 | $354.81 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $323.59 Typical High $660.69 | Professional | AS · PA/NP assist | $83.18 | $323.59 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $9,332.54 | Facility | None | $1,202.26 | $2,818.38 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,122.02 | $2,884.03 |
DeanCare Setting Facility Modifier None Typical Low $741.31 Median $5,128.61 Typical High $9,332.54 | Facility | None | $741.31 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,862.09 | Professional | None | $977.24 | $1,348.96 | $1,862.09 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $2,041.74 Typical High $2,754.23 | Professional | 50 · Both sides | $1,445.44 | $2,041.74 | $2,754.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $213.80 Typical High $295.12 | Professional | 80 · Assistant surgeon | $154.88 | $213.80 | $295.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $190.55 Typical High $257.04 | Professional | AS · PA/NP assist | $134.90 | $190.55 | $257.04 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,548.13 Typical High $9,549.93 | Facility | None | $933.25 | $3,548.13 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,659.59 Typical High $4,677.35 | Professional | None | $676.08 | $1,659.59 | $4,677.35 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $1,905.46 | Professional | None | $776.25 | $1,479.11 | $1,905.46 |
Prevea360 Setting Facility Modifier None Typical Low $616.60 Median $870.96 Typical High $1,230.27 | Facility | None | $616.60 | $870.96 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $660.69 Median $1,513.56 Typical High $2,691.53 | Professional | None | $660.69 | $1,513.56 | $2,691.53 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $6,165.95 Typical High $10,232.93 | Facility | None | $933.25 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $3,090.30 Typical High $4,365.16 | Professional | None | $1,737.80 | $3,090.30 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,288.25 Typical High $3,019.95 | Professional | None | $645.65 | $1,288.25 | $3,019.95 |
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 $309.03 Median $309.03 Typical High $3,019.95 | Professional | 52 · Reduced service | $309.03 | $309.03 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $1,202.26 | Professional | 53 · Discontinued | $123.03 | $123.03 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $4,570.88 | Professional | 54 · Surgery only | $457.09 | $457.09 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $912.01 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $602.56 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $4,265.80 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $676.08 Typical High $933.25 | Professional | 51 · Multiple procedures | $489.78 | $676.08 | $933.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,071.52 Typical High $1,479.11 | Professional | 54 · Surgery only | $776.25 | $1,071.52 | $1,479.11 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $269.15 Typical High $371.54 | Professional | 55 · Aftercare only | $194.98 | $269.15 | $371.54 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,122.02 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $812.83 | $1,122.02 | $1,548.82 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $213.80 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $154.88 | $213.80 | $295.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $213.80 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $213.80 | $295.12 |
Where Wisconsin sits
The same service costs 8.3 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
$2,089
AK $2,570TX $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.