How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,259 to $14,454Professionalmedian $1,622 · 10th to 90th $891 to $7,079
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 $891.25 Median $8,317.64 Typical High $14,454.40 | Facility | None | $891.25 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $8,128.31 | Professional | None | $851.14 | $891.25 | $8,128.31 |
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 $831.76 Median $2,691.53 Typical High $6,456.54 | Professional | None | $831.76 | $2,691.53 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $7,585.78 | Facility | None | $1,202.26 | $3,311.31 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $3,467.37 | Professional | None | $977.24 | $1,096.48 | $3,467.37 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $5,128.61 Typical High $9,332.54 | Facility | None | $933.25 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,659.59 | $2,754.23 |
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 $977.24 Median $3,090.30 Typical High $7,079.46 | Professional | None | $977.24 | $3,090.30 | $7,079.46 |
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 $1,122.02 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,995.26 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,659.59 | Facility | None | $891.25 | $933.25 | $1,659.59 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,659.59 Typical High $3,548.13 | Professional | None | $794.33 | $1,659.59 | $3,548.13 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $5,011.87 Typical High $8,317.64 | Facility | None | $933.25 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,096.48 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $4,570.88 | Professional | None | $2,691.53 | $3,548.13 | $4,570.88 |
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 $831.76 Median $1,412.54 Typical High $3,715.35 | Professional | None | $831.76 | $1,412.54 | $3,715.35 |
14 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 $426.58 Median $446.68 Typical High $4,073.80 | Professional | 52 · Reduced service | $426.58 | $446.68 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $1,659.59 | Professional | 53 · Discontinued | $169.82 | $181.97 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $6,165.95 | Professional | 54 · Surgery only | $630.96 | $676.08 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $1,230.27 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $812.83 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $5,754.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $707.95 Median $831.76 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $707.95 | $831.76 | $1,380.38 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,348.96 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,148.15 | $1,348.96 | $2,187.76 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $331.13 Typical High $549.54 | Professional | 55 · Aftercare only | $281.84 | $331.13 | $549.54 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,412.54 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,412.54 | $2,290.87 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $436.52 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $436.52 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $229.09 Median $269.15 Typical High $436.52 | Professional | 81 · Minimal assistant surgeon | $229.09 | $269.15 | $436.52 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $229.09 Median $269.15 Typical High $436.52 | Professional | 82 · Assistant surgeon, no resident | $229.09 | $269.15 | $436.52 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $380.19 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $380.19 |
Where Wisconsin sits
The same service costs 6.5 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
$1,995
AK $3,311TX $513
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.