How much rates vary
Facilitymedian $1,259 · 10th to 90th $282 to $3,802Professionalmedian $447 · 10th to 90th $224 to $1,549
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 $199.53 Median $288.40 Typical High $14,454.40 | Facility | None | $199.53 | $288.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $1,949.84 | Professional | None | $199.53 | $288.40 | $1,949.84 |
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 $245.47 Median $707.95 Typical High $1,659.59 | Professional | None | $245.47 | $707.95 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $1,071.52 | Facility | None | $489.78 | $691.83 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $758.58 | Professional | None | $245.47 | $354.81 | $758.58 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $2,570.40 Typical High $4,786.30 | Facility | None | $208.93 | $2,570.40 | $4,786.30 |
DeanCare Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $707.95 | Professional | None | $316.23 | $457.09 | $707.95 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $954.99 Typical High $1,995.26 | Facility | None | $204.17 | $954.99 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,348.96 Typical High $2,398.83 | Professional | None | $309.03 | $1,348.96 | $2,398.83 |
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 $407.38 Median $575.44 Typical High $707.95 | Professional | None | $407.38 | $575.44 | $707.95 |
Prevea360 Setting Facility Modifier None Typical Low $165.96 Median $281.84 Typical High $537.03 | Facility | None | $165.96 | $281.84 | $537.03 |
Quartz Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $954.99 | Professional | None | $269.15 | $537.03 | $954.99 |
Quartz Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $1,071.52 | Facility | None | $467.74 | $630.96 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $436.52 | Professional | None | $245.47 | $331.13 | $436.52 |
Security Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $977.24 | Professional | None | $645.65 | $645.65 | $977.24 |
Security Health Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,318.26 | Professional | None | $616.60 | $912.01 | $1,318.26 |
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 $208.93 Median $363.08 Typical High $1,096.48 | Professional | None | $208.93 | $363.08 | $1,096.48 |
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 $100.00 Median $100.00 Typical High $144.54 | Facility | 52 · Reduced service | $100.00 | $100.00 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $57.54 | Facility | 53 · Discontinued | $39.81 | $39.81 | $57.54 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $213.80 | Facility | 54 · Surgery only | $151.36 | $151.36 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $42.66 | Facility | 55 · Aftercare only | $30.20 | $30.20 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $28.84 | Facility | 56 · Pre-op care only | $19.95 | $19.95 | $28.84 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $141.25 Typical High $199.53 | Facility | 78 · Unplanned return to OR | $141.25 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $144.54 Typical High $954.99 | Professional | 52 · Reduced service | $100.00 | $144.54 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $57.54 Typical High $389.05 | Professional | 53 · Discontinued | $39.81 | $57.54 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $213.80 Typical High $1,445.44 | Professional | 54 · Surgery only | $151.36 | $213.80 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $42.66 Typical High $288.40 | Professional | 55 · Aftercare only | $30.20 | $42.66 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $28.84 Typical High $194.98 | Professional | 56 · Pre-op care only | $19.95 | $28.84 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $1,348.96 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $229.09 Typical High $354.81 | Professional | 51 · Multiple procedures | $158.49 | $229.09 | $354.81 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $363.08 Typical High $575.44 | Professional | 54 · Surgery only | $251.19 | $363.08 | $575.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $91.20 Typical High $144.54 | Professional | 55 · Aftercare only | $63.10 | $91.20 | $144.54 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $380.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $263.03 | $380.19 | $602.56 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $72.44 Typical High $114.82 | Professional | 80 · Assistant surgeon | $50.12 | $72.44 | $114.82 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $50.12 Median $72.44 Typical High $114.82 | Professional | 81 · Minimal assistant surgeon | $50.12 | $72.44 | $114.82 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $50.12 Median $72.44 Typical High $114.82 | Professional | 82 · Assistant surgeon, no resident | $50.12 | $72.44 | $114.82 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $63.10 Typical High $100.00 | Professional | AS · PA/NP assist | $43.65 | $63.10 | $100.00 |
Where Wisconsin sits
The same service costs 4.2 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
$501
AK $741TX $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.