How much rates vary
Facilitymedian $6,026 · 10th to 90th $776 to $13,183Professionalmedian $562 · 10th to 90th $316 to $2,239
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 $323.59 Median $6,456.54 Typical High $14,454.40 | Facility | None | $323.59 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $2,344.23 | Professional | None | $302.00 | $323.59 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $16,982.44 | Facility | None | $5,754.40 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $954.99 Typical High $2,238.72 | Professional | None | $295.12 | $954.99 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $416.87 | Professional | None | $269.15 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $7,585.78 | Facility | None | $776.25 | $1,445.44 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $1,230.27 | Professional | None | $354.81 | $398.11 | $1,230.27 |
DeanCare Setting Facility Modifier None Typical Low $346.74 Median $5,623.41 Typical High $10,232.93 | Facility | None | $346.74 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $933.25 | Professional | None | $512.86 | $602.56 | $933.25 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $3,388.44 Typical High $9,549.93 | Facility | None | $691.83 | $3,388.44 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,071.52 Typical High $2,630.27 | Professional | None | $338.84 | $1,071.52 | $2,630.27 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $851.14 | Professional | None | $407.38 | $676.08 | $851.14 |
Prevea360 Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $691.83 | Facility | None | $323.59 | $398.11 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $1,258.93 | Professional | None | $288.40 | $602.56 | $1,258.93 |
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 $389.05 Median $398.11 Typical High $512.86 | Professional | None | $389.05 | $398.11 | $512.86 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,584.89 | Professional | None | $891.25 | $1,230.27 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $1,318.26 | Professional | None | $295.12 | $501.19 | $1,318.26 |
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 $147.91 Median $162.18 Typical High $1,174.90 | Professional | 52 · Reduced service | $147.91 | $162.18 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $64.57 Typical High $467.74 | Professional | 53 · Discontinued | $60.26 | $64.57 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $1,778.28 | Professional | 54 · Surgery only | $223.87 | $245.47 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $354.81 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $234.42 | Professional | 56 · Pre-op care only | $30.20 | $32.36 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $229.09 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $208.93 | $229.09 | $1,659.59 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $302.00 Typical High $467.74 | Professional | 51 · Multiple procedures | $257.04 | $302.00 | $467.74 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $758.58 | Professional | 54 · Surgery only | $407.38 | $478.63 | $758.58 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $186.21 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $186.21 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $794.33 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $95.50 Typical High $151.36 | Professional | 80 · Assistant surgeon | $81.28 | $95.50 | $151.36 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $81.28 Median $95.50 Typical High $151.36 | Professional | 81 · Minimal assistant surgeon | $81.28 | $95.50 | $151.36 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $81.28 Median $95.50 Typical High $151.36 | Professional | 82 · Assistant surgeon, no resident | $81.28 | $95.50 | $151.36 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $85.11 Typical High $131.83 | Professional | AS · PA/NP assist | $72.44 | $85.11 | $131.83 |
Where Wisconsin sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 4th of 51
$692
AK $1,202UT $219
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.