How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,454Professionalmedian $3,467 · 10th to 90th $1,318 to $9,772
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 $1,318.26 Median $1,318.26 Typical High $14,454.40 | Facility | None | $1,318.26 | $1,318.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $12,882.50 | Professional | None | $1,318.26 | $1,318.26 | $12,882.50 |
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 $1,348.96 Median $4,677.35 Typical High $10,000.00 | Professional | None | $1,348.96 | $4,677.35 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $2,884.03 Typical High $6,309.57 | Professional | 62 · Two surgeons | $851.14 | $2,884.03 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $741.31 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $213.80 | $741.31 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $645.65 Typical High $1,380.38 | Professional | AS · PA/NP assist | $190.55 | $645.65 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,168.69 Typical High $7,585.78 | Facility | None | $1,023.29 | $4,168.69 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $6,309.57 | Professional | None | $2,187.76 | $2,398.83 | $6,309.57 |
DeanCare Setting Facility Modifier None Typical Low $1,479.11 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,479.11 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,344.23 | $2,884.03 | $3,981.07 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,819.70 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,479.11 | $1,819.70 | $2,511.89 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $467.74 Typical High $645.65 | Professional | 80 · Assistant surgeon | $380.19 | $467.74 | $645.65 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $407.38 Typical High $562.34 | Professional | AS · PA/NP assist | $331.13 | $407.38 | $562.34 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $15,135.61 | Facility | None | $1,230.27 | $6,606.93 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $14,791.08 | Professional | None | $1,445.44 | $3,467.37 | $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 $1,659.59 Median $3,019.95 Typical High $3,890.45 | Professional | None | $1,659.59 | $3,019.95 | $3,890.45 |
Prevea360 Setting Facility Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,754.23 | Facility | None | $1,230.27 | $1,479.11 | $2,754.23 |
Quartz Setting Professional Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $5,754.40 | Professional | None | $1,380.38 | $3,162.28 | $5,754.40 |
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 $2,398.83 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,398.83 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $4,073.80 Median $6,309.57 Typical High $9,772.37 | Professional | None | $4,073.80 | $6,309.57 | $9,772.37 |
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 $1,318.26 Median $2,754.23 Typical High $6,760.83 | Professional | None | $1,318.26 | $2,754.23 | $6,760.83 |
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 $660.69 Median $660.69 Typical High $6,456.54 | Professional | 52 · Reduced service | $660.69 | $660.69 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $2,570.40 | Professional | 53 · Discontinued | $263.03 | $263.03 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $9,549.93 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $1,949.84 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $1,949.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $8,912.51 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,174.90 Median $1,445.44 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $1,174.90 | $1,445.44 | $1,995.26 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,344.23 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,905.46 | $2,344.23 | $3,235.94 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $575.44 Typical High $794.33 | Professional | 55 · Aftercare only | $467.74 | $575.44 | $794.33 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,454.71 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,454.71 | $3,388.44 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $467.74 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $380.19 | $467.74 | $645.65 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $467.74 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $467.74 | $645.65 |
Where Wisconsin sits
The same service costs 17.0 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
$4,365
AK $5,495TX $324
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.