How much rates vary
Facilitymedian $3,981 · 10th to 90th $794 to $8,128Professionalmedian $479 · 10th to 90th $269 to $1,862
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 $275.42 Median $8,317.64 Typical High $14,454.40 | Facility | None | $275.42 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $2,290.87 | Professional | None | $251.19 | $275.42 | $2,290.87 |
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 $245.47 Median $794.33 Typical High $1,862.09 | Professional | None | $245.47 | $794.33 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $3,715.35 | Facility | None | $660.69 | $1,445.44 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $1,047.13 | Professional | None | $323.59 | $338.84 | $1,047.13 |
DeanCare Setting Facility Modifier None Typical Low $288.40 Median $5,128.61 Typical High $9,332.54 | Facility | None | $288.40 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $776.25 | Professional | None | $436.52 | $512.86 | $776.25 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,388.44 Typical High $8,317.64 | Facility | None | $724.44 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $891.25 Typical High $1,862.09 | Professional | None | $288.40 | $891.25 | $1,862.09 |
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 $338.84 Median $562.34 Typical High $724.44 | Professional | None | $338.84 | $562.34 | $724.44 |
Prevea360 Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $933.25 | Facility | None | $275.42 | $338.84 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $1,071.52 | Professional | None | $245.47 | $512.86 | $1,071.52 |
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 $331.13 Median $338.84 Typical High $446.68 | Professional | None | $331.13 | $338.84 | $446.68 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $537.03 Median $1,023.29 Typical High $1,318.26 | Professional | None | $537.03 | $1,023.29 | $1,318.26 |
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 $245.47 Median $416.87 Typical High $1,096.48 | Professional | None | $245.47 | $416.87 | $1,096.48 |
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 $128.82 Median $138.04 Typical High $1,148.15 | Professional | 52 · Reduced service | $128.82 | $138.04 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $457.09 | Professional | 53 · Discontinued | $51.29 | $54.95 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $1,737.80 | Professional | 54 · Surgery only | $190.55 | $208.93 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $346.74 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $229.09 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $1,621.81 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $257.04 Typical High $389.05 | Professional | 51 · Multiple procedures | $218.78 | $257.04 | $389.05 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $616.60 | Professional | 54 · Surgery only | $346.74 | $407.38 | $616.60 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $154.88 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $154.88 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $660.69 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $81.28 Typical High $125.89 | Professional | 80 · Assistant surgeon | $69.18 | $81.28 | $125.89 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $69.18 Median $81.28 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $69.18 | $81.28 | $125.89 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $69.18 Median $81.28 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $69.18 | $81.28 | $125.89 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $72.44 Typical High $109.65 | Professional | AS · PA/NP assist | $60.26 | $72.44 | $109.65 |
Where Wisconsin sits
The same service costs 6.0 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
$603
AK $1,000UT $166
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.