How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $10,965Professionalmedian $2,089 · 10th to 90th $832 to $5,888
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 $831.76 Median $8,317.64 Typical High $14,454.40 | Facility | None | $831.76 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $8,317.64 | Professional | None | $831.76 | $831.76 | $8,317.64 |
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 $812.83 Median $3,019.95 Typical High $6,165.95 | Professional | None | $812.83 | $3,019.95 | $6,165.95 |
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 $1,348.96 Median $1,513.56 Typical High $4,365.16 | Professional | None | $1,348.96 | $1,513.56 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $5,128.61 Typical High $9,332.54 | Facility | None | $933.25 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,819.70 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,000.00 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $2,041.74 Typical High $6,309.57 | Professional | None | $812.83 | $2,041.74 | $6,309.57 |
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 $1,047.13 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,621.81 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $933.25 Typical High $1,584.89 | Facility | None | $851.14 | $933.25 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $2,137.96 Typical High $3,715.35 | Professional | None | $933.25 | $2,137.96 | $3,715.35 |
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 $1,819.70 | Professional | None | $1,513.56 | $1,513.56 | $1,819.70 |
Security Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $1,479.11 Median $4,168.69 Typical High $6,025.60 | Professional | None | $1,479.11 | $4,168.69 | $6,025.60 |
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 $1,737.80 Typical High $4,073.80 | Professional | None | $812.83 | $1,737.80 | $4,073.80 |
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 $4,168.69 | Professional | 52 · Reduced service | $416.87 | $416.87 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,659.59 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $6,165.95 | Professional | 54 · Surgery only | $616.60 | $616.60 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $1,258.93 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $831.76 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $5,754.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $912.01 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $741.31 | $912.01 | $1,258.93 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,445.44 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,174.90 | $1,445.44 | $1,995.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $363.08 Typical High $501.19 | Professional | 55 · Aftercare only | $295.12 | $363.08 | $501.19 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,513.56 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,513.56 | $2,089.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $288.40 Typical High $398.11 | Professional | 80 · Assistant surgeon | $234.42 | $288.40 | $398.11 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $288.40 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $234.42 | $288.40 | $398.11 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $288.40 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $288.40 | $398.11 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $257.04 Typical High $346.74 | Professional | AS · PA/NP assist | $208.93 | $257.04 | $346.74 |
Where Wisconsin sits
The same service costs 7.2 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
$2,818
AK $3,467TX $479
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.