How much rates vary
Facilitymedian $1,202 · 10th to 90th $141 to $3,802Professionalmedian $251 · 10th to 90th $117 to $741
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 $100.00 Median $117.49 Typical High $14,454.40 | Facility | None | $100.00 | $117.49 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $891.25 | Professional | None | $100.00 | $117.49 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $389.05 Typical High $741.31 | Professional | None | $112.20 | $389.05 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $245.47 Typical High $575.44 | Facility | None | $66.07 | $245.47 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $512.86 | Professional | None | $186.21 | $245.47 | $512.86 |
DeanCare Setting Facility Modifier None Typical Low $120.23 Median $2,630.27 Typical High $5,128.61 | Facility | None | $120.23 | $2,630.27 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $338.84 | Professional | None | $199.53 | $263.03 | $338.84 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $812.83 Typical High $1,778.28 | Facility | None | $141.25 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $416.87 Typical High $954.99 | Professional | None | $128.82 | $416.87 | $954.99 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $2,344.23 | Facility | None | $831.76 | $933.25 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $323.59 | Professional | None | $158.49 | $223.87 | $323.59 |
Prevea360 Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $239.88 | Facility | None | $100.00 | $141.25 | $239.88 |
Quartz Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $512.86 | Professional | None | $173.78 | $331.13 | $512.86 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $169.82 Typical High $645.65 | Facility | None | $50.12 | $169.82 | $645.65 |
Quartz Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $281.84 | Professional | None | $208.93 | $245.47 | $281.84 |
Security Health Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | None | $371.54 | $371.54 | $436.52 |
Security Health Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $831.76 | Professional | None | $354.81 | $616.60 | $831.76 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $575.44 | Professional | None | $117.49 | $199.53 | $575.44 |
12 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 Facility Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $89.13 | Facility | 54 · Surgery only | $75.86 | $75.86 | $89.13 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | 78 · Unplanned return to OR | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $660.69 | Professional | 54 · Surgery only | $75.86 | $89.13 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $616.60 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $100.00 Median $131.83 Typical High $169.82 | Professional | 51 · Multiple procedures | $100.00 | $131.83 | $169.82 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $162.18 | $208.93 | $269.15 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $67.61 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $218.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $169.82 | $218.78 | $281.84 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $41.69 Typical High $53.70 | Professional | 80 · Assistant surgeon | $32.36 | $41.69 | $53.70 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $32.36 Median $41.69 Typical High $53.70 | Professional | 81 · Minimal assistant surgeon | $32.36 | $41.69 | $53.70 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $32.36 Median $41.69 Typical High $53.70 | Professional | 82 · Assistant surgeon, no resident | $32.36 | $41.69 | $53.70 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $36.31 Typical High $47.86 | Professional | AS · PA/NP assist | $28.18 | $36.31 | $47.86 |
Where Wisconsin sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 2nd of 51
$302
AK $468KY $105
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.