How much rates vary
Facilitymedian $2,818 · 10th to 90th $708 to $5,888Professionalmedian $891 · 10th to 90th $479 to $3,388
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 $501.19 Median $1,905.46 Typical High $14,454.40 | Facility | None | $501.19 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $4,265.80 | Professional | None | $467.74 | $501.19 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,412.54 Typical High $3,388.44 | Professional | None | $457.09 | $1,412.54 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $3,715.35 | Facility | None | $707.95 | $1,659.59 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,949.84 | Professional | None | $501.19 | $616.60 | $1,949.84 |
DeanCare Setting Facility Modifier None Typical Low $512.86 Median $2,754.23 Typical High $5,128.61 | Facility | None | $512.86 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,479.11 | Professional | None | $794.33 | $933.25 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $6,760.83 | Facility | None | $602.56 | $2,398.83 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,659.59 Typical High $3,388.44 | Professional | None | $501.19 | $1,659.59 | $3,388.44 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,230.27 | Professional | None | $630.96 | $954.99 | $1,230.27 |
Prevea360 Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $870.96 | Facility | None | $416.87 | $537.03 | $870.96 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $1,949.84 | Professional | None | $478.63 | $977.24 | $1,949.84 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $2,454.71 Typical High $4,073.80 | Facility | None | $630.96 | $2,454.71 | $4,073.80 |
Quartz Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $776.25 | Professional | None | $537.03 | $616.60 | $776.25 |
Security Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,819.70 | $2,570.40 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $2,041.74 | Professional | None | $436.52 | $741.31 | $2,041.74 |
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 $234.42 Median $251.19 Typical High $2,089.30 | Professional | 52 · Reduced service | $234.42 | $251.19 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $102.33 Typical High $851.14 | Professional | 53 · Discontinued | $93.33 | $102.33 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $3,162.28 | Professional | 54 · Surgery only | $354.81 | $380.19 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $630.96 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $426.58 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $2,951.21 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $398.11 Median $467.74 Typical High $741.31 | Professional | 51 · Multiple procedures | $398.11 | $467.74 | $741.31 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $758.58 Typical High $1,202.26 | Professional | 54 · Surgery only | $645.65 | $758.58 | $1,202.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $295.12 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $295.12 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $1,258.93 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $239.88 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $239.88 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $128.82 Median $151.36 Typical High $239.88 | Professional | 81 · Minimal assistant surgeon | $128.82 | $151.36 | $239.88 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $128.82 Median $151.36 Typical High $239.88 | Professional | 82 · Assistant surgeon, no resident | $128.82 | $151.36 | $239.88 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $208.93 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $208.93 |
Where Wisconsin sits
The same service costs 6.2 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· 4th of 51
$1,047
AK $1,862TX $302
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.