How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,096 to $13,490Professionalmedian $1,585 · 10th to 90th $589 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 $575.44 Median $575.44 Typical High $14,454.40 | Facility | None | $575.44 | $575.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $6,760.83 | Professional | None | $575.44 | $575.44 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $2,344.23 Typical High $4,168.69 | Professional | None | $588.84 | $2,344.23 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $3,467.37 Typical High $6,165.95 | Professional | 50 · Both sides | $891.25 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $371.54 Typical High $660.69 | Professional | 80 · Assistant surgeon | $93.33 | $371.54 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $323.59 Typical High $575.44 | Professional | AS · PA/NP assist | $83.18 | $323.59 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $3,235.94 | Facility | None | $1,023.29 | $1,949.84 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,174.90 | $2,754.23 |
DeanCare Setting Facility Modifier None Typical Low $724.44 Median $7,943.28 Typical High $14,454.40 | Facility | None | $724.44 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,318.26 | $1,905.46 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,995.26 Typical High $2,884.03 | Professional | 50 · Both sides | $1,621.81 | $1,995.26 | $2,884.03 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $213.80 Typical High $302.00 | Professional | 80 · Assistant surgeon | $173.78 | $213.80 | $302.00 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $186.21 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $186.21 | $269.15 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $4,265.80 Typical High $10,964.78 | Facility | None | $812.83 | $4,265.80 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,778.28 Typical High $4,677.35 | Professional | None | $660.69 | $1,778.28 | $4,677.35 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $1,862.09 | Professional | None | $758.58 | $1,318.26 | $1,862.09 |
Prevea360 Setting Facility Modifier None Typical Low $562.34 Median $794.33 Typical High $1,230.27 | Facility | None | $562.34 | $794.33 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,691.53 | Professional | None | $691.83 | $1,584.89 | $2,691.53 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $3,311.31 | Facility | None | $812.83 | $2,187.76 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,174.90 | $1,412.54 |
Security Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $4,466.84 | Professional | None | $2,041.74 | $3,311.31 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,309.57 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,309.57 | $11,481.54 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $3,467.37 | Professional | None | $616.60 | $1,122.02 | $3,467.37 |
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 Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $3,388.44 | Professional | 52 · Reduced service | $281.84 | $281.84 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $1,348.96 | Professional | 53 · Discontinued | $114.82 | $114.82 | $1,348.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $5,128.61 | Professional | 54 · Surgery only | $426.58 | $426.58 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $1,023.29 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $676.08 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $4,786.30 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $537.03 Median $660.69 Typical High $954.99 | Professional | 51 · Multiple procedures | $537.03 | $660.69 | $954.99 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | 54 · Surgery only | $851.14 | $1,047.13 | $1,513.56 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $263.03 Typical High $380.19 | Professional | 55 · Aftercare only | $213.80 | $263.03 | $380.19 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,122.02 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $912.01 | $1,122.02 | $1,584.89 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $173.78 Median $213.80 Typical High $302.00 | Professional | 81 · Minimal assistant surgeon | $173.78 | $213.80 | $302.00 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $173.78 Median $213.80 Typical High $302.00 | Professional | 82 · Assistant surgeon, no resident | $173.78 | $213.80 | $302.00 |
Where Wisconsin sits
The same service costs 5.8 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· 2nd of 51
$2,089
AK $2,570UT $447
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.