How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,202 to $18,621Professionalmedian $1,950 · 10th to 90th $759 to $5,623
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 $758.58 Median $6,456.54 Typical High $14,454.40 | Facility | None | $758.58 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $8,511.38 | Professional | None | $758.58 | $758.58 | $8,511.38 |
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 $741.31 Median $2,691.53 Typical High $5,888.44 | Professional | None | $741.31 | $2,691.53 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $4,073.80 Typical High $8,511.38 | Professional | 50 · Both sides | $1,096.48 | $4,073.80 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $436.52 Typical High $912.01 | Professional | 80 · Assistant surgeon | $117.49 | $436.52 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $380.19 Typical High $794.33 | Professional | AS · PA/NP assist | $102.33 | $380.19 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,691.53 Typical High $9,332.54 | Facility | None | $954.99 | $2,691.53 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,348.96 | $3,548.13 |
DeanCare Setting Facility Modifier None Typical Low $831.76 Median $4,365.16 Typical High $7,762.47 | Facility | None | $831.76 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,659.59 | $2,344.23 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,454.71 Typical High $3,548.13 | Professional | 50 · Both sides | $1,995.26 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | 80 · Assistant surgeon | $213.80 | $263.03 | $380.19 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $229.09 Typical High $331.13 | Professional | AS · PA/NP assist | $186.21 | $229.09 | $331.13 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $13,803.84 | Facility | None | $912.01 | $5,623.41 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,089.30 Typical High $6,606.93 | Professional | None | $870.96 | $2,089.30 | $6,606.93 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $954.99 Median $1,862.09 Typical High $2,290.87 | Professional | None | $954.99 | $1,862.09 | $2,290.87 |
Prevea360 Setting Facility Modifier None Typical Low $741.31 Median $831.76 Typical High $1,548.82 | Facility | None | $741.31 | $831.76 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,819.70 Typical High $3,311.31 | Professional | None | $794.33 | $1,819.70 | $3,311.31 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,232.93 | Facility | None | $758.58 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,348.96 | $1,778.28 |
Security Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $3,801.89 Typical High $5,370.32 | Professional | None | $1,737.80 | $3,801.89 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,621.81 Typical High $3,715.35 | Professional | None | $812.83 | $1,621.81 | $3,715.35 |
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 $371.54 Median $371.54 Typical High $4,265.80 | Professional | 52 · Reduced service | $371.54 | $371.54 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $1,698.24 | Professional | 53 · Discontinued | $151.36 | $151.36 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $6,309.57 | Professional | 54 · Surgery only | $562.34 | $562.34 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $1,258.93 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $851.14 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $5,888.44 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $812.83 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $676.08 | $812.83 | $1,174.90 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,071.52 | $1,318.26 | $1,905.46 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | 55 · Aftercare only | $269.15 | $331.13 | $478.63 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,380.38 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,380.38 | $1,995.26 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | 81 · Minimal assistant surgeon | $213.80 | $263.03 | $380.19 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | 82 · Assistant surgeon, no resident | $213.80 | $263.03 | $380.19 |
Where Wisconsin sits
The same service costs 7.6 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
$2,692
AK $3,162TX $417
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.