How much rates vary
Facilitymedian $1,413 · 10th to 90th $200 to $3,802Professionalmedian $324 · 10th to 90th $148 to $955
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 $125.89 Median $151.36 Typical High $14,454.40 | Facility | None | $125.89 | $151.36 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $1,047.13 | Professional | None | $123.03 | $151.36 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,445.44 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $467.74 Typical High $977.24 | Professional | None | $151.36 | $467.74 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $776.25 | Facility | None | $257.04 | $416.87 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $630.96 | Professional | None | $223.87 | $275.42 | $630.96 |
DeanCare Setting Facility Modifier None Typical Low $141.25 Median $2,570.40 Typical High $4,786.30 | Facility | None | $141.25 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $416.87 | Professional | None | $223.87 | $275.42 | $416.87 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $912.01 Typical High $1,995.26 | Facility | None | $169.82 | $912.01 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $616.60 Typical High $1,148.15 | Professional | None | $173.78 | $616.60 | $1,148.15 |
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 $190.55 Median $371.54 Typical High $467.74 | Professional | None | $190.55 | $371.54 | $467.74 |
Prevea360 Setting Facility Modifier None Typical Low $123.03 Median $169.82 Typical High $575.44 | Facility | None | $123.03 | $169.82 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $645.65 | Professional | None | $204.17 | $380.19 | $645.65 |
Quartz Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $1,071.52 | Facility | None | $251.19 | $389.05 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $331.13 | Professional | None | $229.09 | $275.42 | $331.13 |
Security Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | None | $416.87 | $416.87 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $1,000.00 | Professional | None | $436.52 | $794.33 | $1,000.00 |
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 $151.36 Median $302.00 Typical High $724.44 | Professional | None | $151.36 | $302.00 | $724.44 |
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 $63.10 Median $63.10 Typical High $75.86 | Facility | 52 · Reduced service | $63.10 | $63.10 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $30.20 | Facility | 53 · Discontinued | $25.12 | $25.12 | $30.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $114.82 | Facility | 54 · Surgery only | $95.50 | $95.50 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.91 | Facility | 55 · Aftercare only | $19.05 | $19.05 | $22.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $15.14 | Facility | 56 · Pre-op care only | $12.59 | $12.59 | $15.14 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $89.13 Typical High $107.15 | Facility | 78 · Unplanned return to OR | $89.13 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $75.86 Typical High $562.34 | Professional | 52 · Reduced service | $63.10 | $75.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.20 Typical High $223.87 | Professional | 53 · Discontinued | $25.12 | $30.20 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $851.14 | Professional | 54 · Surgery only | $95.50 | $114.82 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $169.82 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $112.20 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $794.33 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $112.20 Median $138.04 Typical High $208.93 | Professional | 51 · Multiple procedures | $112.20 | $138.04 | $208.93 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $331.13 | Professional | 54 · Surgery only | $181.97 | $218.78 | $331.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $83.18 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $83.18 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $234.42 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $190.55 | $234.42 | $346.74 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $44.67 Typical High $66.07 | Professional | 80 · Assistant surgeon | $36.31 | $44.67 | $66.07 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $36.31 Median $44.67 Typical High $66.07 | Professional | 81 · Minimal assistant surgeon | $36.31 | $44.67 | $66.07 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $36.31 Median $44.67 Typical High $66.07 | Professional | 82 · Assistant surgeon, no resident | $36.31 | $44.67 | $66.07 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.90 Typical High $57.54 | Professional | AS · PA/NP assist | $31.62 | $38.90 | $57.54 |
Where Wisconsin sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$372
AK $513DE $135
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.