How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,239 to $18,197Professionalmedian $6,607 · 10th to 90th $2,512 to $19,055
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 $2,511.89 Median $8,317.64 Typical High $14,454.40 | Facility | None | $2,511.89 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $28,840.32 | Professional | None | $2,511.89 | $2,511.89 | $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 $2,511.89 Median $9,332.54 Typical High $19,498.45 | Professional | None | $2,511.89 | $9,332.54 | $19,498.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $5,888.44 Typical High $12,022.64 | Professional | 62 · Two surgeons | $1,584.89 | $5,888.44 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $1,479.11 Typical High $3,090.30 | Professional | 80 · Assistant surgeon | $398.11 | $1,479.11 | $3,090.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $1,318.26 Typical High $2,691.53 | Professional | AS · PA/NP assist | $354.81 | $1,318.26 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $7,762.47 Typical High $12,589.25 | Facility | None | $1,023.29 | $7,762.47 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,570.88 Typical High $12,022.64 | Professional | None | $4,073.80 | $4,570.88 | $12,022.64 |
DeanCare Setting Facility Modifier None Typical Low $2,818.38 Median $5,128.61 Typical High $9,332.54 | Facility | None | $2,818.38 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $4,466.84 Median $5,495.41 Typical High $7,943.28 | Professional | None | $4,466.84 | $5,495.41 | $7,943.28 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $2,818.38 Median $3,467.37 Typical High $5,011.87 | Professional | 62 · Two surgeons | $2,818.38 | $3,467.37 | $5,011.87 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $724.44 | $870.96 | $1,258.93 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $630.96 Median $776.25 Typical High $1,122.02 | Professional | AS · PA/NP assist | $630.96 | $776.25 | $1,122.02 |
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 $2,884.03 Median $7,079.46 Typical High $19,054.61 | Professional | None | $2,884.03 | $7,079.46 | $19,054.61 |
Network Health Setting Facility Modifier None Typical Low $5,128.61 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,128.61 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $3,162.28 Median $6,309.57 Typical High $7,762.47 | Professional | None | $3,162.28 | $6,309.57 | $7,762.47 |
Prevea360 Setting Facility Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $5,370.32 | Facility | None | $2,344.23 | $2,818.38 | $5,370.32 |
Quartz Setting Professional Modifier None Typical Low $2,630.27 Median $6,025.60 Typical High $10,964.78 | Professional | None | $2,630.27 | $6,025.60 | $10,964.78 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $8,317.64 Typical High $12,882.50 | Facility | None | $812.83 | $8,317.64 | $12,882.50 |
Quartz Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $5,888.44 | Professional | None | $4,570.88 | $4,570.88 | $5,888.44 |
Security Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Security Health Setting Professional Modifier None Typical Low $8,317.64 Median $12,882.50 Typical High $18,197.01 | Professional | None | $8,317.64 | $12,882.50 | $18,197.01 |
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 $2,754.23 Median $5,248.07 Typical High $12,882.50 | Professional | None | $2,754.23 | $5,248.07 | $12,882.50 |
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 $1,258.93 Median $1,258.93 Typical High $14,454.40 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $14,454.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $5,754.40 | Professional | 53 · Discontinued | $501.19 | $501.19 | $5,754.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $21,379.62 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $21,379.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $4,365.16 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $4,365.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $2,884.03 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $2,884.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $19,952.62 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $19,952.62 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,238.72 Median $2,754.23 Typical High $3,981.07 | Professional | 51 · Multiple procedures | $2,238.72 | $2,754.23 | $3,981.07 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $4,365.16 Typical High $6,309.57 | Professional | 54 · Surgery only | $3,548.13 | $4,365.16 | $6,309.57 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | 55 · Aftercare only | $891.25 | $1,096.48 | $1,584.89 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,801.89 Median $4,677.35 Typical High $6,606.93 | Professional | 78 · Unplanned return to OR | $3,801.89 | $4,677.35 | $6,606.93 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | 81 · Minimal assistant surgeon | $724.44 | $870.96 | $1,258.93 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $724.44 Median $870.96 Typical High $1,258.93 | Professional | 82 · Assistant surgeon, no resident | $724.44 | $870.96 | $1,258.93 |
Where Wisconsin sits
The same service costs 8.7 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
$7,762
AK $10,715TX $1,230
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.