How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,413 to $14,125Professionalmedian $3,090 · 10th to 90th $1,148 to $8,511
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 $1,122.02 Median $3,090.30 Typical High $14,454.40 | Facility | None | $1,122.02 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $11,748.98 | Professional | None | $1,122.02 | $1,122.02 | $11,748.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $4,365.16 Typical High $9,120.11 | Professional | None | $1,174.90 | $4,365.16 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $2,691.53 Typical High $5,623.41 | Professional | 62 · Two surgeons | $741.31 | $2,691.53 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $691.83 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $186.21 | $691.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $602.56 Typical High $1,258.93 | Professional | AS · PA/NP assist | $162.18 | $602.56 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,981.07 Typical High $7,585.78 | Facility | None | $954.99 | $3,981.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $5,370.32 | Professional | None | $1,905.46 | $2,041.74 | $5,370.32 |
DeanCare Setting Facility Modifier None Typical Low $1,258.93 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,258.93 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $575.44 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $575.44 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $346.74 Typical High $501.19 | Professional | AS · PA/NP assist | $281.84 | $346.74 | $501.19 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $6,606.93 Typical High $13,803.84 | Facility | None | $1,122.02 | $6,606.93 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $3,311.31 Typical High $10,000.00 | Professional | None | $1,318.26 | $3,311.31 | $10,000.00 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,951.21 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,951.21 | $3,548.13 |
Prevea360 Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,398.83 | Facility | None | $1,047.13 | $1,348.96 | $2,398.83 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $4,897.79 | Professional | None | $1,122.02 | $2,570.40 | $4,897.79 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $5,011.87 Typical High $8,317.64 | Facility | None | $758.58 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $6,165.95 Typical High $8,511.38 | Professional | None | $3,890.45 | $6,165.95 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $5,888.44 | Professional | None | $1,258.93 | $2,454.71 | $5,888.44 |
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 $562.34 Median $562.34 Typical High $5,888.44 | Professional | 52 · Reduced service | $562.34 | $562.34 | $5,888.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $2,344.23 | Professional | 53 · Discontinued | $229.09 | $229.09 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $8,709.64 | Professional | 54 · Surgery only | $851.14 | $851.14 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $1,778.28 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $1,778.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $8,128.31 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $1,000.00 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,995.26 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,621.81 | $1,995.26 | $2,884.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $501.19 Typical High $707.95 | Professional | 55 · Aftercare only | $407.38 | $501.19 | $707.95 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,089.30 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,089.30 | $3,019.95 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $398.11 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $323.59 | $398.11 | $575.44 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $398.11 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $398.11 | $575.44 |
Where Wisconsin sits
The same service costs 16.6 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
$3,981
AK $4,677TX $282
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.