How much rates vary
Facilitymedian $2,570 · 10th to 90th $275 to $5,754Professionalmedian $389 · 10th to 90th $191 to $1,318
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 $154.88 Median $251.19 Typical High $14,454.40 | Facility | None | $154.88 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $1,318.26 | Professional | None | $154.88 | $251.19 | $1,318.26 |
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 $208.93 Median $575.44 Typical High $1,513.56 | Professional | None | $208.93 | $575.44 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $537.03 Typical High $1,023.29 | Facility | None | $275.42 | $537.03 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $602.56 | Professional | None | $194.98 | $309.03 | $602.56 |
DeanCare Setting Facility Modifier None Typical Low $158.49 Median $2,630.27 Typical High $5,128.61 | Facility | None | $158.49 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $602.56 | Professional | None | $245.47 | $398.11 | $602.56 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $2,187.76 Typical High $4,786.30 | Facility | None | $263.03 | $2,187.76 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,047.13 Typical High $1,698.24 | Professional | None | $295.12 | $1,047.13 | $1,698.24 |
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 $338.84 Median $537.03 Typical High $588.84 | Professional | None | $338.84 | $537.03 | $588.84 |
Prevea360 Setting Facility Modifier None Typical Low $128.82 Median $239.88 Typical High $446.68 | Facility | None | $128.82 | $239.88 | $446.68 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $457.09 Typical High $851.14 | Professional | None | $218.78 | $457.09 | $851.14 |
Quartz Setting Facility Modifier None Typical Low $275.42 Median $416.87 Typical High $1,071.52 | Facility | None | $275.42 | $416.87 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $371.54 | Professional | None | $194.98 | $295.12 | $371.54 |
Security Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $870.96 | Professional | None | $524.81 | $524.81 | $870.96 |
Security Health Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,148.15 | Professional | None | $524.81 | $812.83 | $1,148.15 |
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 $177.83 Median $323.59 Typical High $977.24 | Professional | None | $177.83 | $323.59 | $977.24 |
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 $77.62 Median $77.62 Typical High $125.89 | Facility | 52 · Reduced service | $77.62 | $77.62 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $50.12 | Facility | 53 · Discontinued | $31.62 | $31.62 | $50.12 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $186.21 | Facility | 54 · Surgery only | $117.49 | $117.49 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $37.15 | Facility | 55 · Aftercare only | $23.44 | $23.44 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $25.12 | Facility | 56 · Pre-op care only | $15.49 | $15.49 | $25.12 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $109.65 Typical High $173.78 | Facility | 78 · Unplanned return to OR | $109.65 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $125.89 Typical High $660.69 | Professional | 52 · Reduced service | $77.62 | $125.89 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $263.03 | Professional | 53 · Discontinued | $31.62 | $50.12 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $186.21 Typical High $1,000.00 | Professional | 54 · Surgery only | $117.49 | $186.21 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $37.15 Typical High $199.53 | Professional | 55 · Aftercare only | $23.44 | $37.15 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $25.12 Typical High $131.83 | Professional | 56 · Pre-op care only | $15.49 | $25.12 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $173.78 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $109.65 | $173.78 | $933.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $123.03 Median $199.53 Typical High $302.00 | Professional | 51 · Multiple procedures | $123.03 | $199.53 | $302.00 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $199.53 | $316.23 | $478.63 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $79.43 Typical High $120.23 | Professional | 55 · Aftercare only | $48.98 | $79.43 | $120.23 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $331.13 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $208.93 | $331.13 | $501.19 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $63.10 Typical High $95.50 | Professional | 80 · Assistant surgeon | $39.81 | $63.10 | $95.50 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $39.81 Median $63.10 Typical High $95.50 | Professional | 81 · Minimal assistant surgeon | $39.81 | $63.10 | $95.50 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $39.81 Median $63.10 Typical High $95.50 | Professional | 82 · Assistant surgeon, no resident | $39.81 | $63.10 | $95.50 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $54.95 Typical High $85.11 | Professional | AS · PA/NP assist | $34.67 | $54.95 | $85.11 |
Where Wisconsin sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$447
AK $575NJ $166
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.