How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,000 to $10,233Professionalmedian $1,778 · 10th to 90th $676 to $5,012
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 $676.08 Median $6,456.54 Typical High $14,454.40 | Facility | None | $676.08 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $6,760.83 | Professional | None | $676.08 | $676.08 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $2,454.71 Typical High $5,011.87 | Professional | None | $660.69 | $2,454.71 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $3,630.78 Typical High $7,413.10 | Professional | 50 · Both sides | $1,000.00 | $3,630.78 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $389.05 Typical High $812.83 | Professional | 80 · Assistant surgeon | $107.15 | $389.05 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $346.74 Typical High $691.83 | Professional | AS · PA/NP assist | $93.33 | $346.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,691.53 Typical High $5,370.32 | Facility | None | $954.99 | $2,691.53 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,230.27 | $3,235.94 |
DeanCare Setting Facility Modifier None Typical Low $812.83 Median $4,365.16 Typical High $7,762.47 | Facility | None | $812.83 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,479.11 | $2,137.96 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,238.72 Typical High $3,235.94 | Professional | 50 · Both sides | $1,819.70 | $2,238.72 | $3,235.94 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | 80 · Assistant surgeon | $194.98 | $239.88 | $346.74 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $208.93 Typical High $302.00 | Professional | AS · PA/NP assist | $169.82 | $208.93 | $302.00 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $8,709.64 | Facility | None | $933.25 | $3,388.44 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,778.28 Typical High $5,754.40 | Professional | None | $724.44 | $1,778.28 | $5,754.40 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $2,089.30 | Professional | None | $851.14 | $1,584.89 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $1,380.38 | Facility | None | $676.08 | $933.25 | $1,380.38 |
Quartz Setting Professional Modifier None Typical Low $724.44 Median $1,659.59 Typical High $2,951.21 | Professional | None | $724.44 | $1,659.59 | $2,951.21 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $3,548.13 Typical High $5,888.44 | Facility | None | $758.58 | $3,548.13 | $5,888.44 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,230.27 | $1,584.89 |
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 $2,041.74 Median $3,467.37 Typical High $4,786.30 | Professional | None | $2,041.74 | $3,467.37 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,412.54 Typical High $3,388.44 | Professional | None | $676.08 | $1,412.54 | $3,388.44 |
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 $338.84 Median $338.84 Typical High $3,388.44 | Professional | 52 · Reduced service | $338.84 | $338.84 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $1,348.96 | Professional | 53 · Discontinued | $134.90 | $134.90 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $5,011.87 | Professional | 54 · Surgery only | $512.86 | $512.86 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $1,000.00 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $676.08 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $4,677.35 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $741.31 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $602.56 | $741.31 | $1,071.52 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,202.26 Typical High $1,737.80 | Professional | 54 · Surgery only | $977.24 | $1,202.26 | $1,737.80 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $426.58 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $426.58 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,258.93 | $1,819.70 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $194.98 | $239.88 | $346.74 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $194.98 | $239.88 | $346.74 |
Where Wisconsin sits
The same service costs 8.5 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
$2,344
AK $2,884TX $339
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.