How much rates vary
Facilitymedian $9,550 · 10th to 90th $891 to $22,387Professionalmedian $1,995 · 10th to 90th $1,047 to $7,762
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 $1,023.29 Typical High $14,454.40 | Facility | None | $1,023.29 | $1,023.29 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $4,073.80 | Professional | None | $1,023.29 | $1,023.29 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $18,620.87 Typical High $25,703.96 | Facility | None | $13,182.57 | $18,620.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $8,511.38 | Professional | None | $1,122.02 | $3,162.28 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,090.30 Typical High $4,677.35 | Facility | None | $812.83 | $3,090.30 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $4,168.69 | Professional | None | $1,071.52 | $1,071.52 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,344.23 | Facility | None | $1,071.52 | $1,288.25 | $2,344.23 |
DeanCare Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,348.96 | $2,290.87 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,454.71 Typical High $18,197.01 | Facility | None | $501.19 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $3,715.35 Typical High $7,762.47 | Professional | None | $1,318.26 | $3,715.35 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Network Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,570.40 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,344.23 | Facility | None | $1,071.52 | $1,288.25 | $2,344.23 |
Prevea360 Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,691.53 Typical High $5,128.61 | Professional | None | $1,148.15 | $2,691.53 | $5,128.61 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,071.52 | $1,737.80 |
Security Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,890.45 Typical High $9,120.11 | Professional | None | $2,570.40 | $3,890.45 | $9,120.11 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $5,248.07 | Professional | None | $1,174.90 | $1,995.26 | $5,248.07 |
13 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 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $3,090.30 | Professional | 54 · Surgery only | $776.25 | $776.25 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $616.60 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $407.38 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,884.03 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $676.08 Median $1,148.15 Typical High $1,380.38 | Professional | 51 · Multiple procedures | $676.08 | $1,148.15 | $1,380.38 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,819.70 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,096.48 | $1,819.70 | $2,238.72 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $457.09 Typical High $549.54 | Professional | 55 · Aftercare only | $269.15 | $457.09 | $549.54 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,445.44 Typical High $1,737.80 | Professional | 62 · Two surgeons | $851.14 | $1,445.44 | $1,737.80 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,949.84 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,949.84 | $2,344.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $371.54 Typical High $446.68 | Professional | 80 · Assistant surgeon | $218.78 | $371.54 | $446.68 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $218.78 Median $371.54 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $218.78 | $371.54 | $446.68 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $218.78 Median $371.54 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $218.78 | $371.54 | $446.68 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $323.59 Typical High $389.05 | Professional | AS · PA/NP assist | $190.55 | $323.59 | $389.05 |
Where Wisconsin sits
The same service costs 16.2 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· 2nd of 51
$2,239
AK $3,090TX $191
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.