How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,000 to $8,318Professionalmedian $1,549 · 10th to 90th $589 to $4,365
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 $588.84 Median $6,456.54 Typical High $14,454.40 | Facility | None | $588.84 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $6,456.54 | Professional | None | $588.84 | $588.84 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $8,709.64 | Facility | None | $2,818.38 | $4,786.30 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $2,089.30 Typical High $4,365.16 | Professional | None | $562.34 | $2,089.30 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $3,162.28 Typical High $6,606.93 | Professional | 50 · Both sides | $851.14 | $3,162.28 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $338.84 Typical High $707.95 | Professional | 80 · Assistant surgeon | $91.20 | $338.84 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $295.12 Typical High $616.60 | Professional | AS · PA/NP assist | $79.43 | $295.12 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,691.53 | Facility | None | $954.99 | $1,698.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,071.52 | $2,754.23 |
DeanCare Setting Facility Modifier None Typical Low $707.95 Median $4,365.16 Typical High $7,762.47 | Facility | None | $707.95 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,288.25 | $1,862.09 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,949.84 Typical High $2,754.23 | Professional | 50 · Both sides | $1,584.89 | $1,949.84 | $2,754.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $204.17 Typical High $295.12 | Professional | 80 · Assistant surgeon | $165.96 | $204.17 | $295.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $257.04 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $8,317.64 | Facility | None | $933.25 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,621.81 Typical High $5,370.32 | Professional | None | $676.08 | $1,621.81 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $741.31 Median $1,479.11 Typical High $1,819.70 | Professional | None | $741.31 | $1,479.11 | $1,819.70 |
Prevea360 Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $1,174.90 | Facility | None | $588.84 | $933.25 | $1,174.90 |
Quartz Setting Professional Modifier None Typical Low $630.96 Median $1,445.44 Typical High $2,570.40 | Professional | None | $630.96 | $1,445.44 | $2,570.40 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,584.89 Typical High $2,691.53 | Facility | None | $758.58 | $1,584.89 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,951.21 | $4,168.69 |
The Alliance Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,548.13 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,677.35 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,677.35 | $8,709.64 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $2,884.03 | Professional | None | $616.60 | $1,258.93 | $2,884.03 |
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 $295.12 Median $295.12 Typical High $3,235.94 | Professional | 52 · Reduced service | $295.12 | $295.12 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $1,288.25 | Professional | 53 · Discontinued | $117.49 | $117.49 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $4,786.30 | Professional | 54 · Surgery only | $436.52 | $436.52 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $954.99 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $645.65 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $4,466.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $645.65 Typical High $933.25 | Professional | 51 · Multiple procedures | $524.81 | $645.65 | $933.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,479.11 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,479.11 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $371.54 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $371.54 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $870.96 | $1,071.52 | $1,548.82 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $165.96 Median $204.17 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $165.96 | $204.17 | $295.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $165.96 Median $204.17 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $165.96 | $204.17 | $295.12 |
Where Wisconsin sits
The same service costs 7.4 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 $2,455TX $331
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.