How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,000 to $9,120Professionalmedian $1,413 · 10th to 90th $562 to $3,981
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 $5,495.41 | Professional | None | $562.34 | $562.34 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,995.26 Typical High $3,981.07 | Professional | None | $537.03 | $1,995.26 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $2,951.21 Typical High $5,888.44 | Professional | 50 · Both sides | $812.83 | $2,951.21 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $316.23 Typical High $630.96 | Professional | 80 · Assistant surgeon | $87.10 | $316.23 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $275.42 Typical High $549.54 | Professional | AS · PA/NP assist | $75.86 | $275.42 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $4,168.69 | Facility | None | $954.99 | $2,344.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $2,630.27 | Professional | None | $912.01 | $1,023.29 | $2,630.27 |
DeanCare Setting Facility Modifier None Typical Low $630.96 Median $4,365.16 Typical High $7,762.47 | Facility | None | $630.96 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $2,630.27 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $2,630.27 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $194.98 Typical High $281.84 | Professional | 80 · Assistant surgeon | $158.49 | $194.98 | $281.84 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $251.19 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $251.19 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $8,709.64 | Facility | None | $912.01 | $3,388.44 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,445.44 Typical High $4,265.80 | Professional | None | $588.84 | $1,445.44 | $4,265.80 |
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 $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 $524.81 Median $676.08 Typical High $1,122.02 | Facility | None | $524.81 | $676.08 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,454.71 | Professional | None | $602.56 | $1,380.38 | $2,454.71 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $4,570.88 | Facility | None | $758.58 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,023.29 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Security Health Setting Professional Modifier None Typical Low $588.84 Median $2,818.38 Typical High $3,981.07 | Professional | None | $588.84 | $2,818.38 | $3,981.07 |
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 $562.34 Median $1,148.15 Typical High $2,754.23 | Professional | None | $562.34 | $1,148.15 | $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 $2,754.23 | Professional | 52 · Reduced service | $281.84 | $281.84 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $1,096.48 | Professional | 53 · Discontinued | $112.20 | $112.20 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $4,168.69 | Professional | 54 · Surgery only | $416.87 | $416.87 | $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 $549.54 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $3,890.45 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $501.19 Median $616.60 Typical High $891.25 | Professional | 51 · Multiple procedures | $501.19 | $616.60 | $891.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $977.24 Typical High $1,412.54 | Professional | 54 · Surgery only | $794.33 | $977.24 | $1,412.54 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $245.47 Typical High $354.81 | Professional | 55 · Aftercare only | $199.53 | $245.47 | $354.81 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,023.29 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $851.14 | $1,023.29 | $1,479.11 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $158.49 Median $194.98 Typical High $281.84 | Professional | 81 · Minimal assistant surgeon | $158.49 | $194.98 | $281.84 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $158.49 Median $194.98 Typical High $281.84 | Professional | 82 · Assistant surgeon, no resident | $158.49 | $194.98 | $281.84 |
Where Wisconsin sits
The same service costs 8.9 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
$1,905
AK $2,344TX $263
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.