How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,202 to $12,882Professionalmedian $1,950 · 10th to 90th $741 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 $741.31 Median $6,456.54 Typical High $14,454.40 | Facility | None | $741.31 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $8,317.64 | Professional | None | $741.31 | $741.31 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,511.38 Typical High $12,882.50 | Facility | None | $5,128.61 | $8,511.38 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $2,754.23 Typical High $5,623.41 | Professional | None | $724.44 | $2,754.23 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $4,073.80 Typical High $8,317.64 | Professional | 50 · Both sides | $1,096.48 | $4,073.80 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $426.58 Typical High $891.25 | Professional | 80 · Assistant surgeon | $117.49 | $426.58 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $389.05 Typical High $776.25 | Professional | AS · PA/NP assist | $102.33 | $389.05 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $4,168.69 | Facility | None | $954.99 | $2,630.27 | $4,168.69 |
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 $891.25 Median $4,365.16 Typical High $7,762.47 | Facility | None | $891.25 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,621.81 | $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 $954.99 Median $6,606.93 Typical High $13,182.57 | Facility | None | $954.99 | $6,606.93 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,089.30 Typical High $6,309.57 | Professional | None | $870.96 | $2,089.30 | $6,309.57 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $933.25 Median $1,862.09 Typical High $2,290.87 | Professional | None | $933.25 | $1,862.09 | $2,290.87 |
Prevea360 Setting Facility Modifier None Typical Low $741.31 Median $933.25 Typical High $1,513.56 | Facility | None | $741.31 | $933.25 | $1,513.56 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,819.70 Typical High $3,235.94 | Professional | None | $794.33 | $1,819.70 | $3,235.94 |
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 $1,348.96 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,348.96 | $1,737.80 |
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 $1,949.84 Median $3,801.89 Typical High $5,248.07 | Professional | None | $1,949.84 | $3,801.89 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,621.81 Typical High $3,715.35 | Professional | None | $794.33 | $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 $4,168.69 | Professional | 52 · Reduced service | $371.54 | $371.54 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $1,659.59 | Professional | 53 · Discontinued | $147.91 | $147.91 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $6,165.95 | Professional | 54 · Surgery only | $562.34 | $562.34 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $1,230.27 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $831.76 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $5,754.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $660.69 Median $812.83 Typical High $1,174.90 | Professional | 51 · Multiple procedures | $660.69 | $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 $467.74 | Professional | 55 · Aftercare only | $269.15 | $331.13 | $467.74 |
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 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
$2,692
AK $3,162TX $380
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.