How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,288 to $14,454Professionalmedian $2,884 · 10th to 90th $1,072 to $7,413
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 $1,023.29 Median $3,090.30 Typical High $14,454.40 | Facility | None | $1,023.29 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $10,715.19 | Professional | None | $1,023.29 | $1,023.29 | $10,715.19 |
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 $1,071.52 Median $4,168.69 Typical High $7,413.10 | Professional | None | $1,071.52 | $4,168.69 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $660.69 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $169.82 | $660.69 | $1,174.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $575.44 Typical High $1,023.29 | Professional | AS · PA/NP assist | $151.36 | $575.44 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $4,897.79 | Professional | None | $1,819.70 | $2,089.30 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $5,888.44 | Facility | None | $1,202.26 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,344.23 | $3,388.44 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $380.19 Typical High $537.03 | Professional | 80 · Assistant surgeon | $309.03 | $380.19 | $537.03 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | AS · PA/NP assist | $269.15 | $331.13 | $478.63 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,148.15 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $8,128.31 | Professional | None | $1,230.27 | $3,235.94 | $8,128.31 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,570.40 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,238.72 | Facility | None | $933.25 | $1,202.26 | $2,238.72 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $4,897.79 | Professional | None | $1,122.02 | $2,570.40 | $4,897.79 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $3,630.78 Typical High $6,025.60 | Facility | None | $724.44 | $3,630.78 | $6,025.60 |
Quartz Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,089.30 | $2,511.89 |
Security Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $3,801.89 Median $6,165.95 Typical High $7,943.28 | Professional | None | $3,801.89 | $6,165.95 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $6,309.57 | Professional | None | $1,174.90 | $1,995.26 | $6,309.57 |
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 $512.86 Median $512.86 Typical High $5,370.32 | Professional | 52 · Reduced service | $512.86 | $512.86 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $2,137.96 | Professional | 53 · Discontinued | $204.17 | $204.17 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $8,128.31 | Professional | 54 · Surgery only | $758.58 | $758.58 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $1,621.81 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $7,585.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,174.90 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $954.99 | $1,174.90 | $1,698.24 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,862.09 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,548.82 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $467.74 Typical High $676.08 | Professional | 55 · Aftercare only | $380.19 | $467.74 | $676.08 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,995.26 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,995.26 | $2,818.38 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $380.19 Typical High $537.03 | Professional | 81 · Minimal assistant surgeon | $309.03 | $380.19 | $537.03 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $380.19 Typical High $537.03 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $380.19 | $537.03 |
Where Wisconsin sits
The same service costs 6.2 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
$3,631
AK $4,571UT $741
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.