How much rates vary
Facilitymedian $5,012 · 10th to 90th $575 to $9,120Professionalmedian $724 · 10th to 90th $331 to $1,905
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 $234.42 Median $363.08 Typical High $14,454.40 | Facility | None | $234.42 | $363.08 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $2,884.03 | Professional | None | $234.42 | $363.08 | $2,884.03 |
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 $323.59 Median $870.96 Typical High $1,862.09 | Professional | None | $323.59 | $870.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $1,318.26 Typical High $2,754.23 | Professional | 50 · Both sides | $489.78 | $1,318.26 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $4,168.69 | Facility | None | $891.25 | $1,659.59 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $1,513.56 | Professional | None | $426.58 | $660.69 | $1,513.56 |
DeanCare Setting Facility Modifier None Typical Low $338.84 Median $3,090.30 Typical High $5,370.32 | Facility | None | $338.84 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $912.01 | Professional | None | $426.58 | $602.56 | $912.01 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $891.25 Typical High $1,380.38 | Professional | 50 · Both sides | $630.96 | $891.25 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $2,951.21 Typical High $8,709.64 | Facility | None | $524.81 | $2,951.21 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $1,513.56 Typical High $2,754.23 | Professional | None | $416.87 | $1,513.56 | $2,754.23 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,122.02 | Professional | None | $457.09 | $724.44 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $234.42 Median $407.38 Typical High $575.44 | Facility | None | $234.42 | $407.38 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $407.38 Median $812.83 Typical High $1,548.82 | Professional | None | $407.38 | $812.83 | $1,548.82 |
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 $426.58 Median $645.65 Typical High $794.33 | Professional | None | $426.58 | $645.65 | $794.33 |
Security Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,202.26 | Professional | None | $776.25 | $776.25 | $1,202.26 |
Security Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,548.82 | $2,398.83 |
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 $295.12 Median $575.44 Typical High $1,621.81 | Professional | None | $295.12 | $575.44 | $1,621.81 |
20 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 Facility Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $181.97 | Facility | 52 · Reduced service | $117.49 | $117.49 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $72.44 | Facility | 53 · Discontinued | $47.86 | $47.86 | $72.44 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $269.15 | Facility | 54 · Surgery only | $177.83 | $177.83 | $269.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $53.70 | Facility | 55 · Aftercare only | $35.48 | $35.48 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $36.31 | Facility | 56 · Pre-op care only | $23.44 | $23.44 | $36.31 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $251.19 | Facility | 78 · Unplanned return to OR | $165.96 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $181.97 Typical High $1,445.44 | Professional | 52 · Reduced service | $117.49 | $181.97 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $72.44 Typical High $575.44 | Professional | 53 · Discontinued | $47.86 | $72.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $269.15 Typical High $2,137.96 | Professional | 54 · Surgery only | $177.83 | $269.15 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $53.70 Typical High $436.52 | Professional | 55 · Aftercare only | $35.48 | $53.70 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $36.31 Typical High $288.40 | Professional | 56 · Pre-op care only | $23.44 | $36.31 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $251.19 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $165.96 | $251.19 | $1,995.26 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $208.93 Median $302.00 Typical High $457.09 | Professional | 51 · Multiple procedures | $208.93 | $302.00 | $457.09 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $478.63 Typical High $724.44 | Professional | 54 · Surgery only | $338.84 | $478.63 | $724.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $120.23 Typical High $181.97 | Professional | 55 · Aftercare only | $85.11 | $120.23 | $181.97 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $501.19 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $354.81 | $501.19 | $776.25 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $95.50 Typical High $147.91 | Professional | 80 · Assistant surgeon | $67.61 | $95.50 | $147.91 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $67.61 Median $95.50 Typical High $147.91 | Professional | 81 · Minimal assistant surgeon | $67.61 | $95.50 | $147.91 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $67.61 Median $95.50 Typical High $147.91 | Professional | 82 · Assistant surgeon, no resident | $67.61 | $95.50 | $147.91 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $83.18 Typical High $128.82 | Professional | AS · PA/NP assist | $58.88 | $83.18 | $128.82 |
Where Wisconsin sits
The same service costs 5.5 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
$851
AK $1,202TX $219
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.