How much rates vary
Facilitymedian $3,236 · 10th to 90th $891 to $8,913Professionalmedian $1,995 · 10th to 90th $794 to $5,754
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 $794.33 Median $3,090.30 Typical High $14,454.40 | Facility | None | $794.33 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $7,244.36 | Professional | None | $794.33 | $794.33 | $7,244.36 |
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 $776.25 Median $3,090.30 Typical High $6,025.60 | Professional | None | $776.25 | $3,090.30 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $501.19 Typical High $954.99 | Professional | 80 · Assistant surgeon | $123.03 | $501.19 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $436.52 Typical High $831.76 | Professional | AS · PA/NP assist | $109.65 | $436.52 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,511.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $4,168.69 | Professional | None | $1,288.25 | $1,445.44 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $5,888.44 | Facility | None | $812.83 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,737.80 | $2,454.71 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $229.09 | $281.84 | $398.11 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $245.47 Typical High $346.74 | Professional | AS · PA/NP assist | $199.53 | $245.47 | $346.74 |
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 $812.83 Median $1,995.26 Typical High $6,025.60 | Professional | None | $812.83 | $1,995.26 | $6,025.60 |
Network Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,513.56 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,778.28 | $2,290.87 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $891.25 Typical High $1,479.11 | Facility | None | $575.44 | $891.25 | $1,479.11 |
Quartz Setting Professional Modifier None Typical Low $870.96 Median $1,995.26 Typical High $3,548.13 | Professional | None | $870.96 | $1,995.26 | $3,548.13 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $4,570.88 | Facility | None | $724.44 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,445.44 | $1,445.44 | $1,819.70 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,890.45 Typical High $5,623.41 | Professional | None | $1,905.46 | $3,890.45 | $5,623.41 |
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 $794.33 Median $1,621.81 Typical High $3,801.89 | Professional | None | $794.33 | $1,621.81 | $3,801.89 |
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 $398.11 Median $398.11 Typical High $3,630.78 | Professional | 52 · Reduced service | $398.11 | $398.11 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $1,479.11 | Professional | 53 · Discontinued | $158.49 | $158.49 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $5,495.41 | Professional | 54 · Surgery only | $602.56 | $602.56 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $1,096.48 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $724.44 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $5,128.61 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $5,128.61 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $870.96 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $707.95 | $870.96 | $1,230.27 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,412.54 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,148.15 | $1,412.54 | $1,995.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $346.74 Typical High $489.78 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $489.78 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,479.11 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,479.11 | $2,089.30 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $281.84 Typical High $398.11 | Professional | 81 · Minimal assistant surgeon | $229.09 | $281.84 | $398.11 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $281.84 Typical High $398.11 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $281.84 | $398.11 |
Where Wisconsin sits
The same service costs 8.3 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
$2,455
AK $3,388TX $407
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.