How much rates vary
Facilitymedian $1,202 · 10th to 90th $85 to $3,802Professionalmedian $178 · 10th to 90th $79 to $490
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 $63.10 Median $85.11 Typical High $14,454.40 | Facility | None | $63.10 | $85.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $575.44 | Professional | None | $63.10 | $85.11 | $575.44 |
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 $83.18 Median $257.04 Typical High $457.09 | Professional | None | $83.18 | $257.04 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $380.19 Typical High $691.83 | Professional | 50 · Both sides | $125.89 | $380.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $117.49 Typical High $380.19 | Facility | None | $54.95 | $117.49 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $363.08 | Professional | None | $123.03 | $177.83 | $363.08 |
DeanCare Setting Facility Modifier None Typical Low $81.28 Median $3,162.28 Typical High $5,888.44 | Facility | None | $81.28 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $229.09 | Professional | None | $120.23 | $162.18 | $229.09 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $245.47 Typical High $346.74 | Professional | 50 · Both sides | $177.83 | $245.47 | $346.74 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $812.83 Typical High $1,778.28 | Facility | None | $128.82 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $331.13 Typical High $691.83 | Professional | None | $95.50 | $331.13 | $691.83 |
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 $114.82 Median $190.55 Typical High $269.15 | Professional | None | $114.82 | $190.55 | $269.15 |
Prevea360 Setting Facility Modifier None Typical Low $63.10 Median $97.72 Typical High $169.82 | Facility | None | $63.10 | $97.72 | $169.82 |
Quartz Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $389.05 | Professional | None | $114.82 | $208.93 | $389.05 |
Quartz Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $144.54 | Facility | None | $50.12 | $87.10 | $144.54 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $208.93 | Professional | None | $131.83 | $173.78 | $208.93 |
Security Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | None | $234.42 | $234.42 | $316.23 |
Security Health Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $575.44 | Professional | None | $251.19 | $398.11 | $575.44 |
The Alliance Setting Professional Modifier None Typical Low $128.82 Median $338.84 Typical High $575.44 | Professional | None | $128.82 | $338.84 | $575.44 |
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 $83.18 Median $141.25 Typical High $398.11 | Professional | None | $83.18 | $141.25 | $398.11 |
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 $47.86 Median $47.86 Typical High $64.57 | Facility | 54 · Surgery only | $47.86 | $47.86 | $64.57 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $44.67 Typical High $60.26 | Facility | 78 · Unplanned return to OR | $44.67 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $64.57 Typical High $426.58 | Professional | 54 · Surgery only | $47.86 | $64.57 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $60.26 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $44.67 | $60.26 | $398.11 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $81.28 Typical High $114.82 | Professional | 51 · Multiple procedures | $60.26 | $81.28 | $114.82 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $128.82 Typical High $181.97 | Professional | 54 · Surgery only | $95.50 | $128.82 | $181.97 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $23.99 | $32.36 | $45.71 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $100.00 | $134.90 | $194.98 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.05 Median $25.70 Typical High $37.15 | Professional | 80 · Assistant surgeon | $19.05 | $25.70 | $37.15 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $19.05 Median $25.70 Typical High $37.15 | Professional | 81 · Minimal assistant surgeon | $19.05 | $25.70 | $37.15 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $19.05 Median $25.70 Typical High $37.15 | Professional | 82 · Assistant surgeon, no resident | $19.05 | $25.70 | $37.15 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $16.60 Median $22.91 Typical High $32.36 | Professional | AS · PA/NP assist | $16.60 | $22.91 | $32.36 |
Where Wisconsin sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$200
AK $269FL $69.18
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.