How much rates vary
Facilitymedian $10,715 · 10th to 90th $2,455 to $18,621Professionalmedian $6,918 · 10th to 90th $2,692 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 $2,691.53 Median $8,317.64 Typical High $14,454.40 | Facility | None | $2,691.53 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $20,892.96 | Professional | None | $2,691.53 | $2,691.53 | $20,892.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $14,791.08 Typical High $22,387.21 | Facility | None | $10,964.78 | $14,791.08 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $9,332.54 Typical High $20,417.38 | Professional | None | $2,691.53 | $9,332.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $1,479.11 Typical High $3,019.95 | Professional | 80 · Assistant surgeon | $436.52 | $1,479.11 | $3,019.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $1,288.25 Typical High $2,691.53 | Professional | AS · PA/NP assist | $380.19 | $1,288.25 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $7,244.36 Typical High $10,715.19 | Facility | None | $1,202.26 | $7,244.36 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $4,897.79 Typical High $12,882.50 | Professional | None | $4,265.80 | $4,897.79 | $12,882.50 |
DeanCare Setting Facility Modifier None Typical Low $3,019.95 Median $5,128.61 Typical High $9,332.54 | Facility | None | $3,019.95 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $4,265.80 Median $5,888.44 Typical High $7,585.78 | Professional | None | $4,265.80 | $5,888.44 | $7,585.78 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $676.08 Median $954.99 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $676.08 | $954.99 | $1,202.26 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $831.76 Typical High $1,071.52 | Professional | AS · PA/NP assist | $602.56 | $831.76 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $7,585.78 Typical High $17,378.01 | Facility | None | $1,318.26 | $7,585.78 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $2,818.38 Median $7,079.46 Typical High $20,892.96 | Professional | None | $2,818.38 | $7,079.46 | $20,892.96 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $7,079.46 | Professional | None | $3,388.44 | $5,370.32 | $7,079.46 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $3,019.95 Typical High $5,623.41 | Facility | None | $933.25 | $3,019.95 | $5,623.41 |
Quartz Setting Professional Modifier None Typical Low $2,818.38 Median $6,456.54 Typical High $11,748.98 | Professional | None | $2,818.38 | $6,456.54 | $11,748.98 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $6,165.95 Typical High $10,232.93 | Facility | None | $933.25 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,897.79 | $4,897.79 | $5,888.44 |
Security Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Security Health Setting Professional Modifier None Typical Low $7,943.28 Median $12,302.69 Typical High $19,498.45 | Professional | None | $7,943.28 | $12,302.69 | $19,498.45 |
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 $2,630.27 Median $5,623.41 Typical High $13,803.84 | Professional | None | $2,630.27 | $5,623.41 | $13,803.84 |
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 $1,348.96 Median $1,348.96 Typical High $10,471.29 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $10,471.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $4,168.69 | Professional | 53 · Discontinued | $537.03 | $537.03 | $4,168.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $15,488.17 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $15,488.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $3,090.30 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $3,090.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $2,089.30 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $2,089.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,905.46 Typical High $14,454.40 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,905.46 | $14,454.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,137.96 Median $2,951.21 Typical High $3,801.89 | Professional | 51 · Multiple procedures | $2,137.96 | $2,951.21 | $3,801.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $4,786.30 Typical High $6,025.60 | Professional | 54 · Surgery only | $3,388.44 | $4,786.30 | $6,025.60 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,174.90 Typical High $1,513.56 | Professional | 55 · Aftercare only | $851.14 | $1,174.90 | $1,513.56 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $5,011.87 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $3,548.13 | $5,011.87 | $6,309.57 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $676.08 Median $954.99 Typical High $1,202.26 | Professional | 81 · Minimal assistant surgeon | $676.08 | $954.99 | $1,202.26 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $676.08 Median $954.99 Typical High $1,202.26 | Professional | 82 · Assistant surgeon, no resident | $676.08 | $954.99 | $1,202.26 |
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
$7,943
AK $11,482TX $589
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.