How much rates vary
Facilitymedian $3,981 · 10th to 90th $759 to $8,128Professionalmedian $407 · 10th to 90th $229 to $1,585
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 $239.88 Median $8,317.64 Typical High $14,454.40 | Facility | None | $239.88 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $1,698.24 | Professional | None | $218.78 | $239.88 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $691.83 Typical High $1,584.89 | Professional | None | $204.17 | $691.83 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,445.44 Typical High $3,715.35 | Facility | None | $575.44 | $1,445.44 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $912.01 | Professional | None | $251.19 | $295.12 | $912.01 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $5,128.61 Typical High $9,332.54 | Facility | None | $251.19 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $676.08 | Professional | None | $380.19 | $446.68 | $676.08 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $8,317.64 | Facility | None | $741.31 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $776.25 Typical High $1,584.89 | Professional | None | $239.88 | $776.25 | $1,584.89 |
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 $295.12 Median $478.63 Typical High $616.60 | Professional | None | $295.12 | $478.63 | $616.60 |
Prevea360 Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $933.25 | Facility | None | $234.42 | $281.84 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $218.78 Median $446.68 Typical High $933.25 | Professional | None | $218.78 | $446.68 | $933.25 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $2,691.53 Typical High $4,265.80 | Facility | None | $933.25 | $2,691.53 | $4,265.80 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $398.11 | Professional | None | $281.84 | $295.12 | $398.11 |
Security Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Security Health Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,148.15 | Professional | None | $537.03 | $891.25 | $1,148.15 |
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 $208.93 Median $346.74 Typical High $933.25 | Professional | None | $208.93 | $346.74 | $933.25 |
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 $109.65 Median $120.23 Typical High $851.14 | Professional | 52 · Reduced service | $109.65 | $120.23 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $346.74 | Professional | 53 · Discontinued | $44.67 | $47.86 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $1,288.25 | Professional | 54 · Surgery only | $165.96 | $177.83 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $36.31 Typical High $257.04 | Professional | 55 · Aftercare only | $33.11 | $36.31 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $169.82 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $165.96 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $154.88 | $165.96 | $1,202.26 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $190.55 Median $223.87 Typical High $338.84 | Professional | 51 · Multiple procedures | $190.55 | $223.87 | $338.84 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $302.00 | $354.81 | $537.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $134.90 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $562.34 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $70.79 Typical High $107.15 | Professional | 80 · Assistant surgeon | $60.26 | $70.79 | $107.15 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $60.26 Median $70.79 Typical High $107.15 | Professional | 81 · Minimal assistant surgeon | $60.26 | $70.79 | $107.15 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $60.26 Median $70.79 Typical High $107.15 | Professional | 82 · Assistant surgeon, no resident | $60.26 | $70.79 | $107.15 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $61.66 Typical High $93.33 | Professional | AS · PA/NP assist | $52.48 | $61.66 | $93.33 |
Where Wisconsin sits
The same service costs 5.6 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· 3rd of 51
$513
AK $871UT $155
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.