How much rates vary
Facilitymedian $5,888 · 10th to 90th $933 to $10,000Professionalmedian $1,000 · 10th to 90th $389 to $2,884
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 $389.05 Median $6,456.54 Typical High $14,454.40 | Facility | None | $389.05 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $3,890.45 | Professional | None | $389.05 | $389.05 | $3,890.45 |
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 $371.54 Median $1,380.38 Typical High $2,951.21 | Professional | None | $371.54 | $1,380.38 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $2,089.30 Typical High $4,365.16 | Professional | 50 · Both sides | $562.34 | $2,089.30 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $9,332.54 | Facility | None | $933.25 | $1,778.28 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,819.70 | Professional | None | $630.96 | $707.95 | $1,819.70 |
DeanCare Setting Facility Modifier None Typical Low $467.74 Median $4,365.16 Typical High $7,762.47 | Facility | None | $467.74 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,174.90 | Professional | None | $616.60 | $851.14 | $1,174.90 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,288.25 Typical High $1,778.28 | Professional | 50 · Both sides | $912.01 | $1,288.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $9,549.93 | Facility | None | $741.31 | $3,388.44 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $1,096.48 Typical High $3,630.78 | Professional | None | $398.11 | $1,096.48 | $3,630.78 |
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 $489.78 Median $912.01 Typical High $1,174.90 | Professional | None | $489.78 | $912.01 | $1,174.90 |
Prevea360 Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $933.25 | Facility | None | $380.19 | $501.19 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $977.24 Typical High $1,698.24 | Professional | None | $426.58 | $977.24 | $1,698.24 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,232.93 | Facility | None | $758.58 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $912.01 | Professional | None | $707.95 | $707.95 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Security Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,995.26 | $2,691.53 |
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 $389.05 Median $812.83 Typical High $1,862.09 | Professional | None | $389.05 | $812.83 | $1,862.09 |
14 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 $194.98 Median $194.98 Typical High $1,949.84 | Professional | 52 · Reduced service | $194.98 | $194.98 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $776.25 | Professional | 53 · Discontinued | $77.62 | $77.62 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $2,951.21 | Professional | 54 · Surgery only | $288.40 | $288.40 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $588.84 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $389.05 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $2,754.23 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $309.03 Median $426.58 Typical High $588.84 | Professional | 51 · Multiple procedures | $309.03 | $426.58 | $588.84 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $676.08 Typical High $933.25 | Professional | 54 · Surgery only | $489.78 | $676.08 | $933.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $169.82 Typical High $234.42 | Professional | 55 · Aftercare only | $123.03 | $169.82 | $234.42 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $724.44 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $512.86 | $724.44 | $977.24 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $138.04 Typical High $186.21 | Professional | 80 · Assistant surgeon | $97.72 | $138.04 | $186.21 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $97.72 Median $138.04 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $97.72 | $138.04 | $186.21 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $97.72 Median $138.04 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $97.72 | $138.04 | $186.21 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $120.23 Typical High $165.96 | Professional | AS · PA/NP assist | $85.11 | $120.23 | $165.96 |
Where Wisconsin sits
The same service costs 7.2 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
$1,380
AK $1,622TX $224
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.