How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,778 to $18,197Professionalmedian $5,248 · 10th to 90th $1,950 to $14,791
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 $1,949.84 Median $1,949.84 Typical High $14,454.40 | Facility | None | $1,949.84 | $1,949.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $24,547.09 | Professional | None | $1,949.84 | $1,949.84 | $24,547.09 |
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 $1,949.84 Median $7,413.10 Typical High $15,135.61 | Professional | None | $1,949.84 | $7,413.10 | $15,135.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $4,677.35 Typical High $9,549.93 | Professional | 62 · Two surgeons | $1,230.27 | $4,677.35 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $1,174.90 Typical High $2,398.83 | Professional | 80 · Assistant surgeon | $316.23 | $1,174.90 | $2,398.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $1,047.13 Typical High $2,089.30 | Professional | AS · PA/NP assist | $275.42 | $1,047.13 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $6,165.95 | Facility | None | $1,023.29 | $2,691.53 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $9,332.54 | Professional | None | $3,311.31 | $3,548.13 | $9,332.54 |
DeanCare Setting Facility Modifier None Typical Low $2,187.76 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,187.76 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,467.37 Median $4,265.80 Typical High $6,165.95 | Professional | None | $3,467.37 | $4,265.80 | $6,165.95 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $2,691.53 Typical High $3,890.45 | Professional | 62 · Two surgeons | $2,187.76 | $2,691.53 | $3,890.45 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $562.34 Median $691.83 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $562.34 | $691.83 | $1,000.00 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $602.56 Typical High $870.96 | Professional | AS · PA/NP assist | $489.78 | $602.56 | $870.96 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $7,244.36 Typical High $15,135.61 | Facility | None | $1,258.93 | $7,244.36 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $19,054.61 | Professional | None | $2,290.87 | $5,754.40 | $19,054.61 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $10,715.19 Typical High $17,378.01 | Facility | None | $3,981.07 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $2,454.71 Median $5,128.61 Typical High $6,165.95 | Professional | None | $2,454.71 | $5,128.61 | $6,165.95 |
Prevea360 Setting Facility Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $4,168.69 | Facility | None | $1,819.70 | $2,344.23 | $4,168.69 |
Quartz Setting Professional Modifier None Typical Low $2,041.74 Median $4,677.35 Typical High $8,511.38 | Professional | None | $2,041.74 | $4,677.35 | $8,511.38 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $3,162.28 | Facility | None | $812.83 | $1,995.26 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,570.88 | Professional | None | $3,548.13 | $3,548.13 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $10,000.00 Typical High $14,125.38 | Professional | None | $4,466.84 | $10,000.00 | $14,125.38 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $4,365.16 Typical High $10,000.00 | Professional | None | $2,137.96 | $4,365.16 | $10,000.00 |
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 $977.24 Median $977.24 Typical High $12,302.69 | Professional | 52 · Reduced service | $977.24 | $977.24 | $12,302.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $4,897.79 | Professional | 53 · Discontinued | $389.05 | $389.05 | $4,897.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $18,620.87 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $18,620.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $3,715.35 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $3,715.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $2,454.71 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $2,454.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $17,378.01 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $17,378.01 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,737.80 Median $2,137.96 Typical High $3,090.30 | Professional | 51 · Multiple procedures | $1,737.80 | $2,137.96 | $3,090.30 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,467.37 Typical High $4,897.79 | Professional | 54 · Surgery only | $2,818.38 | $3,467.37 | $4,897.79 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $851.14 Typical High $1,230.27 | Professional | 55 · Aftercare only | $691.83 | $851.14 | $1,230.27 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,630.78 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,630.78 | $5,248.07 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $562.34 Median $691.83 Typical High $1,000.00 | Professional | 81 · Minimal assistant surgeon | $562.34 | $691.83 | $1,000.00 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $562.34 Median $691.83 Typical High $1,000.00 | Professional | 82 · Assistant surgeon, no resident | $562.34 | $691.83 | $1,000.00 |
Where Wisconsin sits
The same service costs 19.5 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
$6,026
AK $8,318TX $427
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.