How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,288 to $14,454Professionalmedian $2,291 · 10th to 90th $891 to $6,607
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 $891.25 Median $6,456.54 Typical High $14,454.40 | Facility | None | $891.25 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $28,840.32 | Professional | None | $891.25 | $891.25 | $28,840.32 |
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 $891.25 Median $3,235.94 Typical High $7,079.46 | Professional | None | $891.25 | $3,235.94 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $2,041.74 Typical High $4,265.80 | Professional | 62 · Two surgeons | $562.34 | $2,041.74 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $512.86 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $141.25 | $512.86 | $1,071.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $446.68 Typical High $954.99 | Professional | AS · PA/NP assist | $123.03 | $446.68 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $7,585.78 | Facility | None | $1,023.29 | $3,162.28 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,445.44 | $1,621.81 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,000.00 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,949.84 | $2,818.38 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,000.00 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | 80 · Assistant surgeon | $251.19 | $309.03 | $446.68 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $389.05 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $389.05 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $6,606.93 Typical High $15,135.61 | Facility | None | $1,000.00 | $6,606.93 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,454.71 Typical High $8,317.64 | Professional | None | $954.99 | $2,454.71 | $8,317.64 |
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 $1,122.02 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,122.02 | $2,137.96 | $2,754.23 |
Prevea360 Setting Facility Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,819.70 | Facility | None | $831.76 | $1,071.52 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,890.45 | Professional | None | $912.01 | $2,089.30 | $3,890.45 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $5,011.87 Typical High $8,317.64 | Facility | None | $812.83 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,621.81 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $2,951.21 Median $4,168.69 Typical High $6,309.57 | Professional | None | $2,951.21 | $4,168.69 | $6,309.57 |
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 $912.01 Median $1,819.70 Typical High $4,466.84 | Professional | None | $912.01 | $1,819.70 | $4,466.84 |
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 $446.68 Median $446.68 Typical High $14,454.40 | Professional | 52 · Reduced service | $446.68 | $446.68 | $14,454.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $5,888.44 | Professional | 53 · Discontinued | $177.83 | $177.83 | $5,888.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $21,877.62 | Professional | 54 · Surgery only | $660.69 | $660.69 | $21,877.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $4,365.16 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $4,365.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $2,884.03 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $2,884.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $20,417.38 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $20,417.38 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $977.24 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $794.33 | $977.24 | $1,412.54 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $389.05 Typical High $562.34 | Professional | 55 · Aftercare only | $316.23 | $389.05 | $562.34 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,621.81 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,621.81 | $2,344.23 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $251.19 | $309.03 | $446.68 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $251.19 | $309.03 | $446.68 |
Where Wisconsin sits
The same service costs 20.0 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
$3,162
AK $3,715TX $186
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.