How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,072 to $9,120Professionalmedian $2,512 · 10th to 90th $1,023 to $7,586
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 $1,023.29 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,023.29 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $10,715.19 | Professional | None | $1,023.29 | $1,023.29 | $10,715.19 |
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 $1,000.00 Median $3,890.45 Typical High $7,585.78 | Professional | None | $1,000.00 | $3,890.45 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $616.60 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $158.49 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $549.54 Typical High $1,071.52 | Professional | AS · PA/NP assist | $138.04 | $549.54 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,019.95 Typical High $4,570.88 | Facility | None | $1,348.96 | $3,019.95 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $5,248.07 | Professional | None | $1,258.93 | $1,819.70 | $5,248.07 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,000.00 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,819.70 | $2,238.72 | $3,019.95 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $489.78 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $489.78 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $309.03 Typical High $426.58 | Professional | AS · PA/NP assist | $251.19 | $309.03 | $426.58 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,398.83 Typical High $6,760.83 | Facility | None | $707.95 | $2,398.83 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $7,762.47 | Professional | None | $1,096.48 | $2,691.53 | $7,762.47 |
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 $1,288.25 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,288.25 | $2,187.76 | $2,818.38 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,089.30 | Facility | None | $933.25 | $1,148.15 | $2,089.30 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $4,677.35 | Professional | None | $1,071.52 | $2,454.71 | $4,677.35 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $3,019.95 Typical High $4,570.88 | Facility | None | $1,071.52 | $3,019.95 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Security Health Setting Professional Modifier None Typical Low $1,023.29 Median $5,370.32 Typical High $7,244.36 | Professional | None | $1,023.29 | $5,370.32 | $7,244.36 |
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 $1,023.29 Median $2,089.30 Typical High $5,011.87 | Professional | None | $1,023.29 | $2,089.30 | $5,011.87 |
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 $512.86 Median $512.86 Typical High $5,370.32 | Professional | 52 · Reduced service | $512.86 | $512.86 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $2,137.96 | Professional | 53 · Discontinued | $204.17 | $204.17 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $8,128.31 | Professional | 54 · Surgery only | $758.58 | $758.58 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $1,621.81 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $7,585.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,122.02 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $912.01 | $1,122.02 | $1,513.56 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,778.28 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,445.44 | $1,778.28 | $2,454.71 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $446.68 Typical High $616.60 | Professional | 55 · Aftercare only | $363.08 | $446.68 | $616.60 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,862.09 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,862.09 | $2,570.40 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $354.81 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $288.40 | $354.81 | $489.78 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $354.81 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $354.81 | $489.78 |
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
$2,951
AK $4,266TX $562
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.