How much rates vary
Facilitymedian $3,090 · 10th to 90th $759 to $8,913Professionalmedian $1,698 · 10th to 90th $661 to $4,677
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 $660.69 Median $1,905.46 Typical High $14,454.40 | Facility | None | $660.69 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $5,888.44 | Professional | None | $660.69 | $660.69 | $5,888.44 |
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 $645.65 Median $2,630.27 Typical High $4,897.79 | Professional | None | $645.65 | $2,630.27 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $416.87 Typical High $776.25 | Professional | 80 · Assistant surgeon | $104.71 | $416.87 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $363.08 Typical High $676.08 | Professional | AS · PA/NP assist | $91.20 | $363.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,137.96 Typical High $4,168.69 | Facility | None | $707.95 | $2,137.96 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,202.26 | $3,467.37 |
DeanCare Setting Facility Modifier None Typical Low $741.31 Median $2,754.23 Typical High $5,128.61 | Facility | None | $741.31 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,445.44 | $2,041.74 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $323.59 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $281.84 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $281.84 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $2,398.83 Typical High $6,760.83 | Facility | None | $660.69 | $2,398.83 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,659.59 Typical High $5,011.87 | Professional | None | $676.08 | $1,659.59 | $5,011.87 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $1,905.46 | Professional | None | $831.76 | $1,479.11 | $1,905.46 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $1,202.26 | Facility | None | $575.44 | $741.31 | $1,202.26 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,951.21 | Professional | None | $741.31 | $1,737.80 | $2,951.21 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $2,754.23 Typical High $4,570.88 | Facility | None | $630.96 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,202.26 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,162.28 Typical High $4,786.30 | Professional | None | $1,949.84 | $3,162.28 | $4,786.30 |
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 $660.69 Median $1,348.96 Typical High $3,162.28 | Professional | None | $660.69 | $1,348.96 | $3,162.28 |
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 $331.13 Median $331.13 Typical High $2,951.21 | Professional | 52 · Reduced service | $331.13 | $331.13 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,174.90 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $4,466.84 | Professional | 54 · Surgery only | $489.78 | $489.78 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $891.25 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $588.84 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $4,168.69 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $724.44 Typical High $1,000.00 | Professional | 51 · Multiple procedures | $588.84 | $724.44 | $1,000.00 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,621.81 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,621.81 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $407.38 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $407.38 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,230.27 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,230.27 | $1,698.24 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $190.55 | $234.42 | $323.59 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $234.42 | $323.59 |
Where Wisconsin sits
The same service costs 7.8 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
$2,089
AK $2,754TX $355
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.