How much rates vary
Facilitymedian $1,230 · 10th to 90th $191 to $3,802Professionalmedian $295 · 10th to 90th $138 to $955
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 $120.23 Median $194.98 Typical High $14,454.40 | Facility | None | $120.23 | $194.98 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $660.69 | Professional | None | $120.23 | $194.98 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $436.52 Typical High $1,096.48 | Professional | None | $162.18 | $436.52 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $316.23 Typical High $549.54 | Facility | None | $50.12 | $316.23 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $457.09 | Professional | None | $151.36 | $239.88 | $457.09 |
DeanCare Setting Facility Modifier None Typical Low $128.82 Median $2,630.27 Typical High $5,128.61 | Facility | None | $128.82 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $478.63 | Professional | None | $190.55 | $309.03 | $478.63 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $912.01 Typical High $1,778.28 | Facility | None | $154.88 | $912.01 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $812.83 Typical High $1,318.26 | Professional | None | $204.17 | $812.83 | $1,318.26 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $446.68 | Professional | None | $245.47 | $371.54 | $446.68 |
Prevea360 Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $346.74 | Facility | None | $120.23 | $194.98 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $165.96 Median $338.84 Typical High $676.08 | Professional | None | $165.96 | $338.84 | $676.08 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $229.09 Typical High $346.74 | Facility | None | $50.12 | $229.09 | $346.74 |
Quartz Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $281.84 | Professional | None | $151.36 | $204.17 | $281.84 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $660.69 | Professional | None | $398.11 | $398.11 | $660.69 |
Security Health Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $891.25 | Professional | None | $398.11 | $588.84 | $891.25 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $1,862.09 | Facility | None | $218.78 | $1,202.26 | $1,862.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $741.31 | Professional | None | $128.82 | $239.88 | $741.31 |
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 $60.26 Median $60.26 Typical High $97.72 | Facility | 52 · Reduced service | $60.26 | $60.26 | $97.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $38.90 | Facility | 53 · Discontinued | $24.55 | $24.55 | $38.90 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $147.91 | Facility | 54 · Surgery only | $91.20 | $91.20 | $147.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $29.51 | Facility | 55 · Aftercare only | $18.20 | $18.20 | $29.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $19.50 | Facility | 56 · Pre-op care only | $12.02 | $12.02 | $19.50 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $138.04 | Facility | 78 · Unplanned return to OR | $85.11 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $97.72 Typical High $331.13 | Professional | 52 · Reduced service | $60.26 | $97.72 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $38.90 Typical High $134.90 | Professional | 53 · Discontinued | $24.55 | $38.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $147.91 Typical High $501.19 | Professional | 54 · Surgery only | $91.20 | $147.91 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $29.51 Typical High $100.00 | Professional | 55 · Aftercare only | $18.20 | $29.51 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.50 Typical High $66.07 | Professional | 56 · Pre-op care only | $12.02 | $19.50 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $138.04 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $85.11 | $138.04 | $467.74 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $95.50 Median $154.88 Typical High $239.88 | Professional | 51 · Multiple procedures | $95.50 | $154.88 | $239.88 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $251.19 Typical High $380.19 | Professional | 54 · Surgery only | $154.88 | $251.19 | $380.19 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $38.02 | $61.66 | $95.50 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $263.03 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $162.18 | $263.03 | $398.11 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $50.12 Typical High $75.86 | Professional | 80 · Assistant surgeon | $30.90 | $50.12 | $75.86 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $30.90 Median $50.12 Typical High $75.86 | Professional | 81 · Minimal assistant surgeon | $30.90 | $50.12 | $75.86 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $30.90 Median $50.12 Typical High $75.86 | Professional | 82 · Assistant surgeon, no resident | $30.90 | $50.12 | $75.86 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $43.65 Typical High $66.07 | Professional | AS · PA/NP assist | $26.92 | $43.65 | $66.07 |
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
$331
AK $437NJ $126
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.