How much rates vary
Facilitymedian $2,818 · 10th to 90th $407 to $5,888Professionalmedian $513 · 10th to 90th $234 to $1,778
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 $218.78 Median $338.84 Typical High $14,454.40 | Facility | None | $218.78 | $338.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $2,041.74 | Professional | None | $218.78 | $338.84 | $2,041.74 |
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 $295.12 Median $758.58 Typical High $1,862.09 | Professional | None | $295.12 | $758.58 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,096.48 | Facility | None | $446.68 | $741.31 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $831.76 | Professional | None | $269.15 | $416.87 | $831.76 |
DeanCare Setting Facility Modifier None Typical Low $223.87 Median $2,570.40 Typical High $4,786.30 | Facility | None | $223.87 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $812.83 | Professional | None | $346.74 | $537.03 | $812.83 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $2,187.76 Typical High $4,365.16 | Facility | None | $354.81 | $2,187.76 | $4,365.16 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $1,445.44 Typical High $2,290.87 | Professional | None | $316.23 | $1,445.44 | $2,290.87 |
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 $389.05 Median $549.54 Typical High $776.25 | Professional | None | $389.05 | $549.54 | $776.25 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $575.44 | Facility | None | $190.55 | $338.84 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $323.59 Median $630.96 Typical High $1,174.90 | Professional | None | $323.59 | $630.96 | $1,174.90 |
Quartz Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $1,071.52 | Facility | None | $426.58 | $575.44 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $501.19 | Professional | None | $269.15 | $354.81 | $501.19 |
Security Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,174.90 | Professional | None | $741.31 | $741.31 | $1,174.90 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,584.89 | Professional | None | $660.69 | $1,000.00 | $1,584.89 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $1,230.27 | Professional | None | $204.17 | $380.19 | $1,230.27 |
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 $109.65 Median $109.65 Typical High $169.82 | Facility | 52 · Reduced service | $109.65 | $109.65 | $169.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $67.61 | Facility | 53 · Discontinued | $43.65 | $43.65 | $67.61 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $251.19 | Facility | 54 · Surgery only | $162.18 | $162.18 | $251.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $51.29 | Facility | 55 · Aftercare only | $32.36 | $32.36 | $51.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $33.88 | Facility | 56 · Pre-op care only | $21.88 | $21.88 | $33.88 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $234.42 | Facility | 78 · Unplanned return to OR | $151.36 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $169.82 Typical High $1,023.29 | Professional | 52 · Reduced service | $109.65 | $169.82 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $67.61 Typical High $407.38 | Professional | 53 · Discontinued | $43.65 | $67.61 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $251.19 Typical High $1,513.56 | Professional | 54 · Surgery only | $162.18 | $251.19 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $51.29 Typical High $309.03 | Professional | 55 · Aftercare only | $32.36 | $51.29 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.88 Typical High $204.17 | Professional | 56 · Pre-op care only | $21.88 | $33.88 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $234.42 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $151.36 | $234.42 | $1,412.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $269.15 Typical High $407.38 | Professional | 51 · Multiple procedures | $169.82 | $269.15 | $407.38 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $426.58 Typical High $660.69 | Professional | 54 · Surgery only | $275.42 | $426.58 | $660.69 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $107.15 Typical High $162.18 | Professional | 55 · Aftercare only | $69.18 | $107.15 | $162.18 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $691.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $85.11 Typical High $131.83 | Professional | 80 · Assistant surgeon | $54.95 | $85.11 | $131.83 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $54.95 Median $85.11 Typical High $131.83 | Professional | 81 · Minimal assistant surgeon | $54.95 | $85.11 | $131.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $54.95 Median $85.11 Typical High $131.83 | Professional | 82 · Assistant surgeon, no resident | $54.95 | $85.11 | $131.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $75.86 Typical High $114.82 | Professional | AS · PA/NP assist | $47.86 | $75.86 | $114.82 |
Where Wisconsin sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 3rd of 51
$575
AK $794KY $178
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.