How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,692 to $24,547Professionalmedian $8,128 · 10th to 90th $3,090 to $23,442
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 $3,090.30 Median $3,090.30 Typical High $14,454.40 | Facility | None | $3,090.30 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $28,840.32 | Professional | None | $3,090.30 | $3,090.30 | $28,840.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $15,135.61 Typical High $24,547.09 | Facility | None | $10,715.19 | $15,135.61 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $11,748.98 Typical High $23,988.33 | Professional | None | $3,090.30 | $11,748.98 | $23,988.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,677.35 Median $17,378.01 Typical High $35,481.34 | Professional | 50 · Both sides | $4,677.35 | $17,378.01 | $35,481.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,949.84 Median $7,244.36 Typical High $15,135.61 | Professional | 62 · Two surgeons | $1,949.84 | $7,244.36 | $15,135.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $1,862.09 Typical High $3,801.89 | Professional | 80 · Assistant surgeon | $501.19 | $1,862.09 | $3,801.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $1,621.81 Typical High $3,311.31 | Professional | AS · PA/NP assist | $436.52 | $1,621.81 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $10,964.78 Typical High $34,673.69 | Facility | None | $1,023.29 | $10,964.78 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $5,128.61 Median $5,623.41 Typical High $14,791.08 | Professional | None | $5,128.61 | $5,623.41 | $14,791.08 |
DeanCare Setting Facility Modifier None Typical Low $3,467.37 Median $7,943.28 Typical High $14,454.40 | Facility | None | $3,467.37 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $5,495.41 Median $6,760.83 Typical High $9,332.54 | Professional | None | $5,495.41 | $6,760.83 | $9,332.54 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $8,317.64 Median $10,232.93 Typical High $14,125.38 | Professional | 50 · Both sides | $8,317.64 | $10,232.93 | $14,125.38 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $3,467.37 Median $4,265.80 Typical High $5,888.44 | Professional | 62 · Two surgeons | $3,467.37 | $4,265.80 | $5,888.44 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $891.25 Median $1,096.48 Typical High $1,479.11 | Professional | 80 · Assistant surgeon | $891.25 | $1,096.48 | $1,479.11 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $776.25 Median $954.99 Typical High $1,318.26 | Professional | AS · PA/NP assist | $776.25 | $954.99 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $8,511.38 Typical High $19,498.45 | Facility | None | $1,412.54 | $8,511.38 | $19,498.45 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $8,317.64 Typical High $26,915.35 | Professional | None | $3,388.44 | $8,317.64 | $26,915.35 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $3,890.45 Median $6,760.83 Typical High $8,709.64 | Professional | None | $3,890.45 | $6,760.83 | $8,709.64 |
Prevea360 Setting Facility Modifier None Typical Low $2,884.03 Median $3,467.37 Typical High $6,760.83 | Facility | None | $2,884.03 | $3,467.37 | $6,760.83 |
Quartz Setting Professional Modifier None Typical Low $3,235.94 Median $7,413.10 Typical High $13,489.63 | Professional | None | $3,235.94 | $7,413.10 | $13,489.63 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $23,442.29 Typical High $38,018.94 | Facility | None | $812.83 | $23,442.29 | $38,018.94 |
Quartz Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $7,079.46 | Professional | None | $5,623.41 | $5,623.41 | $7,079.46 |
Security Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
Security Health Setting Professional Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $22,387.21 | Professional | None | $10,000.00 | $15,135.61 | $22,387.21 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $6,456.54 Typical High $15,848.93 | Professional | None | $3,311.31 | $6,456.54 | $15,848.93 |
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 $1,548.82 Median $1,548.82 Typical High $14,454.40 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $14,454.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $5,754.40 | Professional | 53 · Discontinued | $616.60 | $616.60 | $5,754.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $21,379.62 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $21,379.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $4,265.80 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $4,265.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $2,884.03 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $2,884.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $19,952.62 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $19,952.62 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,754.23 Median $3,388.44 Typical High $4,677.35 | Professional | 51 · Multiple procedures | $2,754.23 | $3,388.44 | $4,677.35 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $4,466.84 Median $5,495.41 Typical High $7,413.10 | Professional | 54 · Surgery only | $4,466.84 | $5,495.41 | $7,413.10 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,096.48 Median $1,348.96 Typical High $1,862.09 | Professional | 55 · Aftercare only | $1,096.48 | $1,348.96 | $1,862.09 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,677.35 Median $5,754.40 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $4,677.35 | $5,754.40 | $7,762.47 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $891.25 Median $1,096.48 Typical High $1,479.11 | Professional | 81 · Minimal assistant surgeon | $891.25 | $1,096.48 | $1,479.11 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $891.25 Median $1,096.48 Typical High $1,479.11 | Professional | 82 · Assistant surgeon, no resident | $891.25 | $1,096.48 | $1,479.11 |
Where Wisconsin sits
The same service costs 20.4 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
$9,550
AK $13,183TX $646
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.