How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,023 to $10,000Professionalmedian $1,820 · 10th to 90th $724 to $5,370
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 $724.44 Median $6,456.54 Typical High $14,454.40 | Facility | None | $724.44 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $7,762.47 | Professional | None | $724.44 | $724.44 | $7,762.47 |
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 $707.95 Median $2,630.27 Typical High $5,495.41 | Professional | None | $707.95 | $2,630.27 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $3,890.45 Typical High $8,128.31 | Professional | 50 · Both sides | $1,047.13 | $3,890.45 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $416.87 Typical High $870.96 | Professional | 80 · Assistant surgeon | $112.20 | $416.87 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $363.08 Typical High $758.58 | Professional | AS · PA/NP assist | $97.72 | $363.08 | $758.58 |
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 $1,174.90 Median $1,288.25 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,288.25 | $3,388.44 |
DeanCare Setting Facility Modifier None Typical Low $812.83 Median $4,365.16 Typical High $7,762.47 | Facility | None | $812.83 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,584.89 | $2,290.87 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | 50 · Both sides | $1,905.46 | $2,344.23 | $3,388.44 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | 80 · Assistant surgeon | $204.17 | $251.19 | $363.08 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $218.78 Typical High $316.23 | Professional | AS · PA/NP assist | $177.83 | $218.78 | $316.23 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $9,549.93 | Facility | None | $851.14 | $3,388.44 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,949.84 Typical High $5,495.41 | Professional | None | $794.33 | $1,949.84 | $5,495.41 |
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 $912.01 Median $1,737.80 Typical High $2,238.72 | Professional | None | $912.01 | $1,737.80 | $2,238.72 |
Prevea360 Setting Facility Modifier None Typical Low $707.95 Median $812.83 Typical High $1,479.11 | Facility | None | $707.95 | $812.83 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,778.28 Typical High $3,162.28 | Professional | None | $758.58 | $1,778.28 | $3,162.28 |
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 $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,288.25 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $5,128.61 | Professional | None | $1,737.80 | $3,630.78 | $5,128.61 |
The Alliance Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,897.79 | $4,897.79 | $5,888.44 |
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 $758.58 Median $1,479.11 Typical High $3,548.13 | Professional | None | $758.58 | $1,479.11 | $3,548.13 |
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 $363.08 Median $363.08 Typical High $3,890.45 | Professional | 52 · Reduced service | $363.08 | $363.08 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $1,548.82 | Professional | 53 · Discontinued | $144.54 | $144.54 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $5,754.40 | Professional | 54 · Surgery only | $537.03 | $537.03 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $1,148.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $776.25 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $5,370.32 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $794.33 Typical High $1,148.15 | Professional | 51 · Multiple procedures | $645.65 | $794.33 | $1,148.15 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,023.29 | $1,258.93 | $1,819.70 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $316.23 Typical High $457.09 | Professional | 55 · Aftercare only | $257.04 | $316.23 | $457.09 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,318.26 | $1,905.46 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | 81 · Minimal assistant surgeon | $204.17 | $251.19 | $363.08 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $251.19 | $363.08 |
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
$2,455
AK $3,020TX $398
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.