How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,454Professionalmedian $3,715 · 10th to 90th $1,380 to $10,471
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 $1,380.38 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,380.38 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $25,703.96 | Professional | None | $1,380.38 | $1,380.38 | $25,703.96 |
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 $1,412.54 Median $5,248.07 Typical High $10,471.29 | Professional | None | $1,412.54 | $5,248.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $3,235.94 Typical High $6,606.93 | Professional | 62 · Two surgeons | $891.25 | $3,235.94 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $831.76 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $223.87 | $831.76 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $724.44 Typical High $1,479.11 | Professional | AS · PA/NP assist | $199.53 | $724.44 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $7,585.78 | Facility | None | $1,023.29 | $4,365.16 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $6,606.93 | Professional | None | $2,290.87 | $2,511.89 | $6,606.93 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,548.82 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,454.71 | $3,019.95 | $4,365.16 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,905.46 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,548.82 | $1,905.46 | $2,754.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 80 · Assistant surgeon | $398.11 | $489.78 | $707.95 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | AS · PA/NP assist | $346.74 | $426.58 | $616.60 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $5,754.40 Typical High $13,182.57 | Facility | None | $1,148.15 | $5,754.40 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $3,801.89 Typical High $13,489.63 | Professional | None | $1,548.82 | $3,801.89 | $13,489.63 |
Network Health Setting Facility Modifier None Typical Low $2,951.21 Median $9,332.54 Typical High $15,848.93 | Facility | None | $2,951.21 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,737.80 Median $3,467.37 Typical High $4,265.80 | Professional | None | $1,737.80 | $3,467.37 | $4,265.80 |
Prevea360 Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,951.21 | Facility | None | $1,288.25 | $1,659.59 | $2,951.21 |
Quartz Setting Professional Modifier None Typical Low $1,412.54 Median $3,235.94 Typical High $6,025.60 | Professional | None | $1,412.54 | $3,235.94 | $6,025.60 |
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 $2,511.89 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,511.89 | $2,511.89 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $7,244.36 Typical High $10,000.00 | Professional | None | $4,677.35 | $7,244.36 | $10,000.00 |
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 $1,479.11 Median $2,884.03 Typical High $7,079.46 | Professional | None | $1,479.11 | $2,884.03 | $7,079.46 |
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 $691.83 Median $691.83 Typical High $12,882.50 | Professional | 52 · Reduced service | $691.83 | $691.83 | $12,882.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $5,128.61 | Professional | 53 · Discontinued | $275.42 | $275.42 | $5,128.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $19,498.45 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $19,498.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $3,890.45 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $3,890.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $2,570.40 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $2,570.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $18,197.01 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $18,197.01 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,513.56 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $1,230.27 | $1,513.56 | $2,187.76 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,454.71 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,995.26 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $602.56 Typical High $870.96 | Professional | 55 · Aftercare only | $489.78 | $602.56 | $870.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,570.40 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,570.40 | $3,715.35 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $398.11 | $489.78 | $707.95 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $398.11 | $489.78 | $707.95 |
Where Wisconsin sits
The same service costs 17.8 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
$4,677
AK $5,623TX $316
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.