How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,585 to $14,454Professionalmedian $4,365 · 10th to 90th $1,622 to $12,023
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 $1,584.89 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,584.89 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $25,118.86 | Professional | None | $1,584.89 | $1,584.89 | $25,118.86 |
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 $1,621.81 Median $6,025.60 Typical High $12,022.64 | Professional | None | $1,621.81 | $6,025.60 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $3,801.89 Typical High $7,585.78 | Professional | 62 · Two surgeons | $1,023.29 | $3,801.89 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $954.99 Typical High $1,949.84 | Professional | 80 · Assistant surgeon | $257.04 | $954.99 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $851.14 Typical High $1,698.24 | Professional | AS · PA/NP assist | $223.87 | $851.14 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,011.87 Typical High $9,549.93 | Facility | None | $1,023.29 | $5,011.87 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $7,585.78 | Professional | None | $2,630.27 | $2,884.03 | $7,585.78 |
DeanCare Setting Facility Modifier None Typical Low $1,778.28 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,778.28 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $5,011.87 | Professional | None | $2,818.38 | $3,467.37 | $5,011.87 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $2,187.76 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,778.28 | $2,187.76 | $3,162.28 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | 80 · Assistant surgeon | $457.09 | $562.34 | $812.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | AS · PA/NP assist | $398.11 | $489.78 | $707.95 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $5,754.40 Typical High $12,882.50 | Facility | None | $1,148.15 | $5,754.40 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $5,128.61 Typical High $14,454.40 | Professional | None | $1,819.70 | $5,128.61 | $14,454.40 |
Network Health Setting Facility Modifier None Typical Low $3,162.28 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,162.28 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,995.26 Median $4,168.69 Typical High $5,011.87 | Professional | None | $1,995.26 | $4,168.69 | $5,011.87 |
Prevea360 Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,388.44 | Facility | None | $1,479.11 | $1,905.46 | $3,388.44 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,918.31 | Professional | None | $1,621.81 | $3,715.35 | $6,918.31 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $6,456.54 Typical High $10,471.29 | Facility | None | $812.83 | $6,456.54 | $10,471.29 |
Quartz Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,630.78 | Professional | None | $2,884.03 | $2,884.03 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $7,943.28 Typical High $11,481.54 | Professional | None | $5,370.32 | $7,943.28 | $11,481.54 |
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 $1,698.24 Median $3,548.13 Typical High $8,128.31 | Professional | None | $1,698.24 | $3,548.13 | $8,128.31 |
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 $794.33 Median $794.33 Typical High $12,589.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $12,589.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $5,011.87 | Professional | 53 · Discontinued | $316.23 | $316.23 | $5,011.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $19,054.61 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $19,054.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $3,801.89 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $3,801.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $2,511.89 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $2,511.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $17,782.79 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $17,782.79 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,412.54 Median $1,737.80 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,412.54 | $1,737.80 | $2,511.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,818.38 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,290.87 | $2,818.38 | $3,981.07 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $691.83 Typical High $1,000.00 | Professional | 55 · Aftercare only | $562.34 | $691.83 | $1,000.00 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,951.21 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,951.21 | $4,265.80 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $457.09 | $562.34 | $812.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $562.34 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $562.34 | $812.83 |
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
$5,248
AK $6,457TX $331
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.