How much rates vary
Facilitymedian $1,230 · 10th to 90th $224 to $3,802Professionalmedian $490 · 10th to 90th $214 to $1,413
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 $204.17 Median $239.88 Typical High $14,454.40 | Facility | None | $204.17 | $239.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $2,089.30 | Professional | None | $204.17 | $239.88 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $645.65 Typical High $1,412.54 | Professional | None | $218.78 | $645.65 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $977.24 Typical High $2,137.96 | Professional | 50 · Both sides | $331.13 | $977.24 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $338.84 Typical High $776.25 | Facility | None | $50.12 | $338.84 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $1,000.00 | Professional | None | $331.13 | $436.52 | $1,000.00 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $2,630.27 Typical High $5,128.61 | Facility | None | $229.09 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $630.96 | Professional | None | $363.08 | $446.68 | $630.96 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $660.69 Typical High $933.25 | Professional | 50 · Both sides | $537.03 | $660.69 | $933.25 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $912.01 Typical High $1,778.28 | Facility | None | $204.17 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $912.01 Typical High $1,819.70 | Professional | None | $213.80 | $912.01 | $1,819.70 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $616.60 | Professional | None | $302.00 | $389.05 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $446.68 | Facility | None | $194.98 | $239.88 | $446.68 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $630.96 Typical High $912.01 | Professional | None | $338.84 | $630.96 | $912.01 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $245.47 Typical High $371.54 | Facility | None | $50.12 | $245.47 | $371.54 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $501.19 | Professional | None | $363.08 | $436.52 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | None | $645.65 | $645.65 | $776.25 |
Security Health Setting Professional Modifier None Typical Low $501.19 Median $1,071.52 Typical High $1,548.82 | Professional | None | $501.19 | $1,071.52 | $1,548.82 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $1,071.52 | Professional | None | $190.55 | $436.52 | $1,071.52 |
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 $100.00 Median $100.00 Typical High $120.23 | Facility | 52 · Reduced service | $100.00 | $100.00 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $47.86 | Facility | 53 · Discontinued | $40.74 | $40.74 | $47.86 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $181.97 | Facility | 54 · Surgery only | $151.36 | $151.36 | $181.97 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $36.31 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.99 | Facility | 56 · Pre-op care only | $20.42 | $20.42 | $23.99 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | 78 · Unplanned return to OR | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $120.23 Typical High $1,047.13 | Professional | 52 · Reduced service | $100.00 | $120.23 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $47.86 Typical High $426.58 | Professional | 53 · Discontinued | $40.74 | $47.86 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $1,584.89 | Professional | 54 · Surgery only | $151.36 | $181.97 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $316.23 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.99 Typical High $208.93 | Professional | 56 · Pre-op care only | $20.42 | $23.99 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $1,479.11 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $181.97 Median $223.87 Typical High $316.23 | Professional | 51 · Multiple procedures | $181.97 | $223.87 | $316.23 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $354.81 Typical High $501.19 | Professional | 54 · Surgery only | $288.40 | $354.81 | $501.19 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $125.89 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $125.89 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $371.54 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $302.00 | $371.54 | $524.81 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $70.79 Typical High $100.00 | Professional | 80 · Assistant surgeon | $57.54 | $70.79 | $100.00 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $70.79 Typical High $100.00 | Professional | 81 · Minimal assistant surgeon | $57.54 | $70.79 | $100.00 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $70.79 Typical High $100.00 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $70.79 | $100.00 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $61.66 Typical High $87.10 | Professional | AS · PA/NP assist | $50.12 | $61.66 | $87.10 |
Where Wisconsin sits
The same service costs 5.0 times more in Alaska than in Florida. 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
$525
AK $832FL $166
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.