How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,479 to $14,125Professionalmedian $3,631 · 10th to 90th $1,349 to $10,233
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 $1,348.96 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,348.96 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $19,498.45 | Professional | None | $1,348.96 | $1,348.96 | $19,498.45 |
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 $5,128.61 Typical High $10,471.29 | Professional | None | $1,348.96 | $5,128.61 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $3,162.28 Typical High $6,606.93 | Professional | 62 · Two surgeons | $831.76 | $3,162.28 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $812.83 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $213.80 | $812.83 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $707.95 Typical High $1,445.44 | Professional | AS · PA/NP assist | $186.21 | $707.95 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,265.80 Typical High $7,585.78 | Facility | None | $1,023.29 | $4,265.80 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $6,456.54 | Professional | None | $2,238.72 | $2,454.71 | $6,456.54 |
DeanCare Setting Facility Modifier None Typical Low $1,513.56 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,513.56 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,398.83 | $2,951.21 | $4,265.80 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,513.56 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $478.63 Typical High $676.08 | Professional | 80 · Assistant surgeon | $389.05 | $478.63 | $676.08 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $416.87 Typical High $602.56 | Professional | AS · PA/NP assist | $338.84 | $416.87 | $602.56 |
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 $1,584.89 Median $3,801.89 Typical High $11,481.54 | Professional | None | $1,584.89 | $3,801.89 | $11,481.54 |
Network Health Setting Facility Modifier None Typical Low $3,019.95 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,019.95 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,698.24 Median $3,630.78 Typical High $4,265.80 | Professional | None | $1,698.24 | $3,630.78 | $4,265.80 |
Prevea360 Setting Facility Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,818.38 | Facility | None | $1,258.93 | $1,621.81 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,888.44 | Professional | None | $1,348.96 | $3,090.30 | $5,888.44 |
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 $2,454.71 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,454.71 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $4,168.69 Median $7,413.10 Typical High $9,772.37 | Professional | None | $4,168.69 | $7,413.10 | $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 $1,479.11 Median $2,754.23 Typical High $6,760.83 | Professional | None | $1,479.11 | $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 $676.08 Median $676.08 Typical High $9,772.37 | Professional | 52 · Reduced service | $676.08 | $676.08 | $9,772.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $3,890.45 | Professional | 53 · Discontinued | $269.15 | $269.15 | $3,890.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $14,791.08 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $2,951.21 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $2,951.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $1,949.84 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $1,949.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $13,803.84 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $13,803.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,202.26 Median $1,479.11 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,202.26 | $1,479.11 | $2,137.96 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,344.23 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,949.84 | $2,344.23 | $3,388.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $588.84 Typical High $851.14 | Professional | 55 · Aftercare only | $478.63 | $588.84 | $851.14 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,511.89 | $3,548.13 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $478.63 Typical High $676.08 | Professional | 81 · Minimal assistant surgeon | $389.05 | $478.63 | $676.08 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $478.63 Typical High $676.08 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $478.63 | $676.08 |
Where Wisconsin sits
The same service costs 9.1 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
$4,467
AK $5,623TX $617
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.