How much rates vary
Facilitymedian $3,311 · 10th to 90th $955 to $9,120Professionalmedian $2,188 · 10th to 90th $851 to $6,310
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 $851.14 Median $8,317.64 Typical High $14,454.40 | Facility | None | $851.14 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $7,943.28 | Professional | None | $851.14 | $851.14 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $6,760.83 Typical High $11,481.54 | Facility | None | $2,041.74 | $6,760.83 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $3,235.94 Typical High $6,456.54 | Professional | None | $812.83 | $3,235.94 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $4,365.16 | Facility | None | $1,202.26 | $2,630.27 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $4,365.16 | Professional | None | $1,380.38 | $1,513.56 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $5,128.61 Typical High $9,332.54 | Facility | None | $954.99 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,862.09 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $6,309.57 | Facility | None | $691.83 | $2,398.83 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $2,187.76 Typical High $6,760.83 | Professional | None | $891.25 | $2,187.76 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,995.26 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $691.83 Median $954.99 Typical High $1,737.80 | Facility | None | $691.83 | $954.99 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,890.45 | Professional | None | $912.01 | $2,089.30 | $3,890.45 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $3,019.95 Typical High $4,570.88 | Facility | None | $933.25 | $3,019.95 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,513.56 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $6,025.60 | Professional | None | $2,511.89 | $4,365.16 | $6,025.60 |
The Alliance Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,309.57 | Professional | None | $5,128.61 | $5,128.61 | $6,309.57 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,737.80 Typical High $4,168.69 | Professional | None | $851.14 | $1,737.80 | $4,168.69 |
14 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 $416.87 Median $416.87 Typical High $3,981.07 | Professional | 52 · Reduced service | $416.87 | $416.87 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $1,584.89 | Professional | 53 · Discontinued | $169.82 | $169.82 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $6,025.60 | Professional | 54 · Surgery only | $630.96 | $630.96 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $1,202.26 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $794.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $5,623.41 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $933.25 Typical High $1,318.26 | Professional | 51 · Multiple procedures | $758.58 | $933.25 | $1,318.26 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $2,137.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $371.54 Typical High $537.03 | Professional | 55 · Aftercare only | $302.00 | $371.54 | $537.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 80 · Assistant surgeon | $239.88 | $295.12 | $426.58 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 81 · Minimal assistant surgeon | $239.88 | $295.12 | $426.58 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 82 · Assistant surgeon, no resident | $239.88 | $295.12 | $426.58 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $257.04 Typical High $371.54 | Professional | AS · PA/NP assist | $208.93 | $257.04 | $371.54 |
Where Wisconsin sits
The same service costs 7.1 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
$2,630
AK $3,548TX $501
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.