How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,413 to $14,454Professionalmedian $2,138 · 10th to 90th $1,175 to $9,120
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 $1,174.90 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,174.90 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $15,135.61 | Professional | None | $1,122.02 | $1,174.90 | $15,135.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $7,943.28 | Professional | None | $1,096.48 | $3,467.37 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $562.34 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $181.97 | $562.34 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $489.78 Typical High $1,122.02 | Professional | AS · PA/NP assist | $154.88 | $489.78 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,801.89 Typical High $7,585.78 | Facility | None | $1,348.96 | $3,801.89 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $4,466.84 | Professional | None | $1,174.90 | $1,445.44 | $4,466.84 |
DeanCare Setting Facility Modifier None Typical Low $1,174.90 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,174.90 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,187.76 | $3,630.78 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $346.74 Typical High $588.84 | Professional | 80 · Assistant surgeon | $295.12 | $346.74 | $588.84 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $512.86 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $512.86 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,174.90 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $11,481.54 | Professional | None | $1,258.93 | $4,073.80 | $11,481.54 |
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 $1,479.11 Median $2,511.89 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,511.89 | $3,235.94 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,174.90 Typical High $2,137.96 | Facility | None | $933.25 | $1,174.90 | $2,137.96 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $4,570.88 | Professional | None | $1,071.52 | $2,238.72 | $4,570.88 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $5,011.87 Typical High $8,317.64 | Facility | None | $1,071.52 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,445.44 | $1,778.28 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $4,466.84 Typical High $5,888.44 | Professional | None | $3,235.94 | $4,466.84 | $5,888.44 |
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 $1,096.48 Median $1,819.70 Typical High $4,897.79 | Professional | None | $1,096.48 | $1,819.70 | $4,897.79 |
12 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 $562.34 Median $588.84 Typical High $7,585.78 | Professional | 52 · Reduced service | $562.34 | $588.84 | $7,585.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $3,019.95 | Professional | 53 · Discontinued | $223.87 | $234.42 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $11,481.54 | Professional | 54 · Surgery only | $831.76 | $891.25 | $11,481.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $2,290.87 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $1,513.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $10,715.19 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $933.25 Median $1,096.48 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $933.25 | $1,096.48 | $1,819.70 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,737.80 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,479.11 | $1,737.80 | $2,884.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $436.52 Typical High $724.44 | Professional | 55 · Aftercare only | $371.54 | $436.52 | $724.44 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,819.70 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,819.70 | $3,090.30 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $346.74 Typical High $588.84 | Professional | 81 · Minimal assistant surgeon | $295.12 | $346.74 | $588.84 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $346.74 Typical High $588.84 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $346.74 | $588.84 |
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· 3rd of 51
$2,512
AK $4,365TX $708
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.