How much rates vary
Facilitymedian $3,311 · 10th to 90th $631 to $12,303Professionalmedian $759 · 10th to 90th $363 to $2,630
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 $338.84 Median $524.81 Typical High $14,454.40 | Facility | None | $338.84 | $524.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $2,884.03 | Professional | None | $338.84 | $524.81 | $2,884.03 |
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 $416.87 Median $1,148.15 Typical High $2,754.23 | Professional | None | $416.87 | $1,148.15 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,698.24 | Facility | None | $676.08 | $1,096.48 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,288.25 | Professional | None | $416.87 | $645.65 | $1,288.25 |
DeanCare Setting Facility Modifier None Typical Low $338.84 Median $2,630.27 Typical High $5,128.61 | Facility | None | $338.84 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,148.15 | Professional | None | $537.03 | $831.76 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $3,890.45 Typical High $12,882.50 | Facility | None | $524.81 | $3,890.45 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $2,238.72 Typical High $3,467.37 | Professional | None | $489.78 | $2,238.72 | $3,467.37 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,202.26 | Professional | None | $660.69 | $933.25 | $1,202.26 |
Prevea360 Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $794.33 | Facility | None | $316.23 | $501.19 | $794.33 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $1,621.81 | Professional | None | $501.19 | $977.24 | $1,621.81 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,288.25 | Facility | None | $645.65 | $831.76 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $758.58 | Professional | None | $416.87 | $524.81 | $758.58 |
Security Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,096.48 | $1,737.80 |
Security Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,479.11 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,862.09 | Professional | None | $331.13 | $588.84 | $1,862.09 |
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 $169.82 Median $169.82 Typical High $263.03 | Facility | 52 · Reduced service | $169.82 | $169.82 | $263.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $104.71 | Facility | 53 · Discontinued | $67.61 | $67.61 | $104.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $389.05 | Facility | 54 · Surgery only | $257.04 | $257.04 | $389.05 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $79.43 | Facility | 55 · Aftercare only | $51.29 | $51.29 | $79.43 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $52.48 | Facility | 56 · Pre-op care only | $33.88 | $33.88 | $52.48 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $363.08 | Facility | 78 · Unplanned return to OR | $239.88 | $239.88 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $263.03 Typical High $1,445.44 | Professional | 52 · Reduced service | $169.82 | $263.03 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $104.71 Typical High $575.44 | Professional | 53 · Discontinued | $67.61 | $104.71 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $389.05 Typical High $2,137.96 | Professional | 54 · Surgery only | $257.04 | $389.05 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $426.58 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $52.48 Typical High $288.40 | Professional | 56 · Pre-op care only | $33.88 | $52.48 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $363.08 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $239.88 | $363.08 | $1,995.26 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $269.15 Median $416.87 Typical High $562.34 | Professional | 51 · Multiple procedures | $269.15 | $416.87 | $562.34 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $660.69 Typical High $912.01 | Professional | 54 · Surgery only | $436.52 | $660.69 | $912.01 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $165.96 Typical High $229.09 | Professional | 55 · Aftercare only | $107.15 | $165.96 | $229.09 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $691.83 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $457.09 | $691.83 | $954.99 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $131.83 Typical High $181.97 | Professional | 80 · Assistant surgeon | $87.10 | $131.83 | $181.97 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $87.10 Median $131.83 Typical High $181.97 | Professional | 81 · Minimal assistant surgeon | $87.10 | $131.83 | $181.97 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $87.10 Median $131.83 Typical High $181.97 | Professional | 82 · Assistant surgeon, no resident | $87.10 | $131.83 | $181.97 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $117.49 Typical High $158.49 | Professional | AS · PA/NP assist | $75.86 | $117.49 | $158.49 |
Where Wisconsin sits
The same service costs 4.3 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
$871
AK $1,259KY $295
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.