How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $10,965Professionalmedian $2,138 · 10th to 90th $851 to $6,026
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 $6,456.54 Typical High $14,454.40 | Facility | None | $851.14 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $8,912.51 | Professional | None | $851.14 | $851.14 | $8,912.51 |
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 $831.76 Median $3,311.31 Typical High $6,025.60 | Professional | None | $831.76 | $3,311.31 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $5,011.87 Typical High $8,912.51 | Professional | 50 · Both sides | $1,230.27 | $5,011.87 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $537.03 Typical High $954.99 | Professional | 80 · Assistant surgeon | $131.83 | $537.03 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $467.74 Typical High $831.76 | Professional | AS · PA/NP assist | $114.82 | $467.74 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,691.53 Typical High $4,265.80 | Facility | None | $954.99 | $2,691.53 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $4,466.84 | Professional | None | $1,380.38 | $1,513.56 | $4,466.84 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $4,365.16 Typical High $7,762.47 | Facility | None | $954.99 | $4,365.16 | $7,762.47 |
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 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,754.23 Typical High $3,981.07 | Professional | 50 · Both sides | $2,238.72 | $2,754.23 | $3,981.07 |
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 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 |
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 $891.25 Median $2,187.76 Typical High $6,456.54 | Professional | None | $891.25 | $2,187.76 | $6,456.54 |
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 $1,071.52 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,949.84 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $691.83 Median $954.99 Typical High $1,584.89 | Facility | None | $691.83 | $954.99 | $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 $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 $1,513.56 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,513.56 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,168.69 Typical High $6,025.60 | Professional | None | $2,511.89 | $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 $851.14 Median $1,737.80 Typical High $4,073.80 | Professional | None | $851.14 | $1,737.80 | $4,073.80 |
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 $426.58 Median $426.58 Typical High $4,466.84 | Professional | 52 · Reduced service | $426.58 | $426.58 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $1,778.28 | Professional | 53 · Discontinued | $169.82 | $169.82 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $6,606.93 | Professional | 54 · Surgery only | $630.96 | $630.96 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $1,348.96 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $891.25 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $6,165.95 |
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 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 |
Where Wisconsin sits
The same service costs 7.9 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
$2,884
AK $3,548TX $447
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.