How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,413 to $14,454Professionalmedian $3,162 · 10th to 90th $1,230 to $9,120
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 $1,202.26 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,202.26 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $15,488.17 | Professional | None | $1,202.26 | $1,202.26 | $15,488.17 |
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 $1,230.27 Median $4,466.84 Typical High $9,120.11 | Professional | None | $1,230.27 | $4,466.84 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $2,818.38 Typical High $5,754.40 | Professional | 62 · Two surgeons | $776.25 | $2,818.38 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $707.95 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $194.98 | $707.95 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $616.60 Typical High $1,288.25 | Professional | AS · PA/NP assist | $173.78 | $616.60 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,981.07 Typical High $7,585.78 | Facility | None | $1,023.29 | $3,981.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $5,754.40 | Professional | None | $1,995.26 | $2,187.76 | $5,754.40 |
DeanCare Setting Facility Modifier None Typical Low $1,348.96 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,348.96 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,630.27 | $3,801.89 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,348.96 | $1,659.59 | $2,398.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | 80 · Assistant surgeon | $346.74 | $426.58 | $616.60 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $371.54 Typical High $537.03 | Professional | AS · PA/NP assist | $302.00 | $371.54 | $537.03 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $13,803.84 | Facility | None | $1,148.15 | $6,606.93 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $14,791.08 | Professional | None | $1,348.96 | $3,311.31 | $14,791.08 |
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 $1,513.56 Median $3,090.30 Typical High $3,801.89 | Professional | None | $1,513.56 | $3,090.30 | $3,801.89 |
Prevea360 Setting Facility Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,570.40 | Facility | None | $1,122.02 | $1,445.44 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $2,818.38 Typical High $5,248.07 | Professional | None | $1,230.27 | $2,818.38 | $5,248.07 |
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 $2,187.76 Median $2,187.76 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,187.76 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $6,165.95 Typical High $8,709.64 | Professional | None | $3,890.45 | $6,165.95 | $8,709.64 |
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 $1,288.25 Median $2,511.89 Typical High $6,165.95 | Professional | None | $1,288.25 | $2,511.89 | $6,165.95 |
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 $602.56 Median $602.56 Typical High $7,762.47 | Professional | 52 · Reduced service | $602.56 | $602.56 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $3,162.28 | Professional | 53 · Discontinued | $239.88 | $239.88 | $3,162.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $11,748.98 | Professional | 54 · Surgery only | $912.01 | $912.01 | $11,748.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $2,344.23 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $10,964.78 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $10,964.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $1,071.52 | $1,318.26 | $1,905.46 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,137.96 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,737.80 | $2,137.96 | $3,090.30 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $537.03 Typical High $758.58 | Professional | 55 · Aftercare only | $436.52 | $537.03 | $758.58 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,238.72 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,238.72 | $3,235.94 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $346.74 | $426.58 | $616.60 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $426.58 | $616.60 |
Where Wisconsin sits
The same service costs 14.5 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
$4,074
AK $4,898TX $339
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.