How much rates vary
Facilitymedian $3,236 · 10th to 90th $692 to $7,762Professionalmedian $1,072 · 10th to 90th $447 to $2,754
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 $354.81 Median $575.44 Typical High $14,454.40 | Facility | None | $354.81 | $575.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $4,265.80 | Professional | None | $354.81 | $575.44 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $1,288.25 Typical High $2,570.40 | Professional | None | $478.63 | $1,288.25 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,905.46 Typical High $3,890.45 | Professional | 50 · Both sides | $724.44 | $1,905.46 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $3,090.30 | Facility | None | $1,000.00 | $1,905.46 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $2,454.71 | Professional | None | $630.96 | $1,047.13 | $2,454.71 |
DeanCare Setting Facility Modifier None Typical Low $398.11 Median $3,090.30 Typical High $5,370.32 | Facility | None | $398.11 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,479.11 | Professional | None | $630.96 | $912.01 | $1,479.11 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,380.38 Typical High $2,187.76 | Professional | 50 · Both sides | $954.99 | $1,380.38 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $8,317.64 | Facility | None | $691.83 | $2,818.38 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $2,290.87 Typical High $4,365.16 | Professional | None | $602.56 | $2,290.87 | $4,365.16 |
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 $724.44 Median $1,071.52 Typical High $1,584.89 | Professional | None | $724.44 | $1,071.52 | $1,584.89 |
Prevea360 Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $933.25 | Facility | None | $331.13 | $588.84 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $707.95 Median $1,380.38 Typical High $2,344.23 | Professional | None | $707.95 | $1,380.38 | $2,344.23 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $3,235.94 | Facility | None | $724.44 | $2,137.96 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,258.93 | Professional | None | $645.65 | $912.01 | $1,258.93 |
Security Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,148.15 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,348.96 | $2,290.87 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,677.35 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,677.35 | $8,709.64 |
United Setting Professional Modifier None Typical Low $389.05 Median $870.96 Typical High $2,454.71 | Professional | None | $389.05 | $870.96 | $2,454.71 |
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 $177.83 Median $177.83 Typical High $288.40 | Facility | 52 · Reduced service | $177.83 | $177.83 | $288.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $114.82 | Facility | 53 · Discontinued | $70.79 | $70.79 | $114.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $436.52 | Facility | 54 · Surgery only | $263.03 | $263.03 | $436.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $87.10 | Facility | 55 · Aftercare only | $53.70 | $53.70 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $57.54 | Facility | 56 · Pre-op care only | $35.48 | $35.48 | $57.54 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $407.38 | Facility | 78 · Unplanned return to OR | $245.47 | $245.47 | $407.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $288.40 Typical High $2,137.96 | Professional | 52 · Reduced service | $177.83 | $288.40 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $114.82 Typical High $851.14 | Professional | 53 · Discontinued | $70.79 | $114.82 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $436.52 Typical High $3,162.28 | Professional | 54 · Surgery only | $263.03 | $436.52 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $87.10 Typical High $630.96 | Professional | 55 · Aftercare only | $53.70 | $87.10 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $57.54 Typical High $426.58 | Professional | 56 · Pre-op care only | $35.48 | $57.54 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $407.38 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $245.47 | $407.38 | $2,951.21 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $316.23 Median $457.09 Typical High $724.44 | Professional | 51 · Multiple procedures | $316.23 | $457.09 | $724.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $724.44 Typical High $1,174.90 | Professional | 54 · Surgery only | $501.19 | $724.44 | $1,174.90 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $181.97 Typical High $295.12 | Professional | 55 · Aftercare only | $125.89 | $181.97 | $295.12 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $758.58 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $537.03 | $758.58 | $1,230.27 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $144.54 Typical High $234.42 | Professional | 80 · Assistant surgeon | $102.33 | $144.54 | $234.42 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $144.54 Typical High $234.42 | Professional | 81 · Minimal assistant surgeon | $102.33 | $144.54 | $234.42 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $144.54 Typical High $234.42 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $144.54 | $234.42 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $128.82 Typical High $204.17 | Professional | AS · PA/NP assist | $89.13 | $128.82 | $204.17 |
Where Wisconsin sits
The same service costs 4.7 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
$1,259
AK $1,660TX $355
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.