How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,000 to $7,943Professionalmedian $1,122 · 10th to 90th $617 to $4,169
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 $616.60 Median $3,090.30 Typical High $14,454.40 | Facility | None | $616.60 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $5,011.87 | Professional | None | $602.56 | $616.60 | $5,011.87 |
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 $537.03 Median $1,819.70 Typical High $4,073.80 | Professional | None | $537.03 | $1,819.70 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,089.30 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $2,344.23 | Professional | None | $691.83 | $1,047.13 | $2,344.23 |
DeanCare Setting Facility Modifier None Typical Low $616.60 Median $3,162.28 Typical High $5,888.44 | Facility | None | $616.60 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,819.70 | Professional | None | $977.24 | $1,148.15 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $8,317.64 | Facility | None | $933.25 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $2,041.74 Typical High $4,168.69 | Professional | None | $616.60 | $2,041.74 | $4,168.69 |
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 $758.58 Median $1,148.15 Typical High $1,479.11 | Professional | None | $758.58 | $1,148.15 | $1,479.11 |
Prevea360 Setting Facility Modifier None Typical Low $588.84 Median $645.65 Typical High $1,122.02 | Facility | None | $588.84 | $645.65 | $1,122.02 |
Quartz Setting Professional Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,398.83 | Professional | None | $630.96 | $1,288.25 | $2,398.83 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $3,981.07 | Facility | None | $724.44 | $2,398.83 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,288.25 | Professional | None | $724.44 | $1,047.13 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,737.80 | $2,238.72 | $3,090.30 |
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 $562.34 Median $912.01 Typical High $2,511.89 | Professional | None | $562.34 | $912.01 | $2,511.89 |
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 $302.00 Median $309.03 Typical High $2,511.89 | Professional | 52 · Reduced service | $302.00 | $309.03 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $1,000.00 | Professional | 53 · Discontinued | $120.23 | $123.03 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $3,715.35 | Professional | 54 · Surgery only | $457.09 | $457.09 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $758.58 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $501.19 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $3,467.37 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | 51 · Multiple procedures | $489.78 | $575.44 | $912.01 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $776.25 | $912.01 | $1,445.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $363.08 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $363.08 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,513.56 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $288.40 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $288.40 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $181.97 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $154.88 | $181.97 | $288.40 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $181.97 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $181.97 | $288.40 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $257.04 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $257.04 |
Where Wisconsin sits
The same service costs 5.5 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
$1,318
AK $2,344TX $427
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.