How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,047 to $14,454Professionalmedian $1,413 · 10th to 90th $513 to $3,890
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 $512.86 Median $3,090.30 Typical High $14,454.40 | Facility | None | $512.86 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $5,248.07 | Professional | None | $512.86 | $512.86 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,511.38 Typical High $12,882.50 | Facility | None | $5,128.61 | $8,511.38 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $1,905.46 Typical High $3,890.45 | Professional | None | $501.19 | $1,905.46 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $302.00 Typical High $630.96 | Professional | 80 · Assistant surgeon | $81.28 | $302.00 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $263.03 Typical High $549.54 | Professional | AS · PA/NP assist | $70.79 | $263.03 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,137.96 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $2,454.71 | Professional | None | $891.25 | $977.24 | $2,454.71 |
DeanCare Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $5,888.44 | Facility | None | $616.60 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,621.81 | Professional | None | $912.01 | $1,122.02 | $1,621.81 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $263.03 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $263.03 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $158.49 Typical High $229.09 | Professional | AS · PA/NP assist | $128.82 | $158.49 | $229.09 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $7,943.28 Typical High $15,135.61 | Facility | None | $977.24 | $7,943.28 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,737.80 Typical High $6,309.57 | Professional | None | $616.60 | $1,737.80 | $6,309.57 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $645.65 Median $1,318.26 Typical High $1,621.81 | Professional | None | $645.65 | $1,318.26 | $1,621.81 |
Prevea360 Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $1,047.13 | Facility | None | $512.86 | $831.76 | $1,047.13 |
Quartz Setting Professional Modifier None Typical Low $549.54 Median $1,258.93 Typical High $2,238.72 | Professional | None | $549.54 | $1,258.93 | $2,238.72 |
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 $933.25 Median $933.25 Typical High $1,202.26 | Professional | None | $933.25 | $933.25 | $1,202.26 |
Security Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,630.27 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $2,570.40 | Professional | None | $575.44 | $1,202.26 | $2,570.40 |
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 $257.04 Median $257.04 Typical High $2,630.27 | Professional | 52 · Reduced service | $257.04 | $257.04 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $1,047.13 | Professional | 53 · Discontinued | $102.33 | $102.33 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $3,890.45 | Professional | 54 · Surgery only | $389.05 | $389.05 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $776.25 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $524.81 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $3,630.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | 51 · Multiple procedures | $457.09 | $562.34 | $812.83 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $1,288.25 | Professional | 54 · Surgery only | $741.31 | $912.01 | $1,288.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $223.87 Typical High $323.59 | Professional | 55 · Aftercare only | $181.97 | $223.87 | $323.59 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $1,380.38 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $147.91 Median $181.97 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $147.91 | $181.97 | $263.03 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $147.91 Median $181.97 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $147.91 | $181.97 | $263.03 |
Where Wisconsin sits
The same service costs 6.6 times more in Alaska than in Utah. 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
$1,862
AK $2,188UT $331
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.