How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,072 to $13,490Professionalmedian $1,413 · 10th to 90th $513 to $3,802
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 $489.78 Median $8,511.38 Typical High $14,454.40 | Facility | None | $489.78 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $5,754.40 | Professional | None | $489.78 | $489.78 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $16,982.44 | Facility | None | $5,754.40 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $1,862.09 Typical High $4,365.16 | Professional | None | $524.81 | $1,862.09 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $1,174.90 Typical High $2,754.23 | Professional | 62 · Two surgeons | $331.13 | $1,174.90 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,238.72 Typical High $7,585.78 | Facility | None | $1,230.27 | $2,238.72 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,290.87 | Professional | None | $812.83 | $891.25 | $2,290.87 |
DeanCare Setting Facility Modifier None Typical Low $588.84 Median $5,623.41 Typical High $10,232.93 | Facility | None | $588.84 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,548.82 | Professional | None | $891.25 | $1,071.52 | $1,548.82 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | 62 · Two surgeons | $549.54 | $676.08 | $977.24 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $3,388.44 Typical High $9,549.93 | Facility | None | $776.25 | $3,388.44 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,412.54 Typical High $5,888.44 | Professional | None | $575.44 | $1,412.54 | $5,888.44 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $616.60 Median $1,412.54 Typical High $1,621.81 | Professional | None | $616.60 | $1,412.54 | $1,621.81 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $1,023.29 | Facility | None | $489.78 | $707.95 | $1,023.29 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $1,148.15 Typical High $2,290.87 | Professional | None | $501.19 | $1,148.15 | $2,290.87 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $5,011.87 Typical High $8,317.64 | Facility | None | $1,071.52 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,754.23 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,096.48 Typical High $2,570.40 | Professional | None | $537.03 | $1,096.48 | $2,570.40 |
14 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 $245.47 Median $245.47 Typical High $2,884.03 | Professional | 52 · Reduced service | $245.47 | $245.47 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $1,148.15 | Professional | 53 · Discontinued | $97.72 | $97.72 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $4,365.16 | Professional | 54 · Surgery only | $371.54 | $371.54 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $870.96 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $575.44 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $4,073.80 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $436.52 Median $537.03 Typical High $776.25 | Professional | 51 · Multiple procedures | $436.52 | $537.03 | $776.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $870.96 Typical High $1,258.93 | Professional | 54 · Surgery only | $707.95 | $870.96 | $1,258.93 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $218.78 Typical High $309.03 | Professional | 55 · Aftercare only | $177.83 | $218.78 | $309.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $741.31 | $912.01 | $1,318.26 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $173.78 Typical High $251.19 | Professional | 80 · Assistant surgeon | $141.25 | $173.78 | $251.19 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $173.78 Typical High $251.19 | Professional | 81 · Minimal assistant surgeon | $141.25 | $173.78 | $251.19 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $173.78 Typical High $251.19 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $173.78 | $251.19 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $151.36 Typical High $218.78 | Professional | AS · PA/NP assist | $123.03 | $151.36 | $218.78 |
Where Wisconsin sits
The same service costs 18.2 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
$1,862
AK $1,995TX $110
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.