How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,023 to $14,454Professionalmedian $977 · 10th to 90th $550 to $4,266
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 $549.54 Median $6,456.54 Typical High $14,454.40 | Facility | None | $549.54 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $5,754.40 | Professional | None | $524.81 | $549.54 | $5,754.40 |
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 $512.86 Median $1,621.81 Typical High $3,890.45 | Professional | None | $512.86 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $263.03 Typical High $616.60 | Professional | 80 · Assistant surgeon | $79.43 | $263.03 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $234.42 Typical High $549.54 | Professional | AS · PA/NP assist | $69.18 | $234.42 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $7,585.78 | Facility | None | $954.99 | $2,238.72 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $2,089.30 | Professional | None | $602.56 | $676.08 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $575.44 Median $4,365.16 Typical High $7,762.47 | Facility | None | $575.44 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,659.59 | Professional | None | $870.96 | $1,023.29 | $1,659.59 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $263.03 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $263.03 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $234.42 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $234.42 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $15,848.93 | Facility | None | $954.99 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,862.09 Typical High $4,786.30 | Professional | None | $602.56 | $1,862.09 | $4,786.30 |
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 $691.83 Median $1,202.26 Typical High $1,548.82 | Professional | None | $691.83 | $1,202.26 | $1,548.82 |
Prevea360 Setting Facility Modifier None Typical Low $537.03 Median $630.96 Typical High $1,000.00 | Facility | None | $537.03 | $630.96 | $1,000.00 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $1,000.00 Typical High $2,137.96 | Professional | None | $489.78 | $1,000.00 | $2,137.96 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $8,317.64 | Facility | None | $758.58 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $831.76 | Professional | None | $645.65 | $676.08 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Security Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,621.81 | $2,137.96 | $2,754.23 |
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 $501.19 Median $851.14 Typical High $2,238.72 | Professional | None | $501.19 | $851.14 | $2,238.72 |
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 $257.04 Median $275.42 Typical High $2,884.03 | Professional | 52 · Reduced service | $257.04 | $275.42 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $1,148.15 | Professional | 53 · Discontinued | $104.71 | $109.65 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $4,365.16 | Professional | 54 · Surgery only | $389.05 | $407.38 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $870.96 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $575.44 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $4,073.80 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $512.86 Typical High $831.76 | Professional | 51 · Multiple procedures | $436.52 | $512.86 | $831.76 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $812.83 Typical High $1,318.26 | Professional | 54 · Surgery only | $691.83 | $812.83 | $1,318.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $331.13 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $331.13 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $1,380.38 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $138.04 Median $162.18 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $138.04 | $162.18 | $263.03 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $138.04 Median $162.18 Typical High $263.03 | Professional | 82 · Assistant surgeon, no resident | $138.04 | $162.18 | $263.03 |
Where Wisconsin sits
The same service costs 6.3 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
$1,202
AK $2,042TX $324
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.