How much rates vary
Facilitymedian $1,950 · 10th to 90th $631 to $4,677Professionalmedian $1,349 · 10th to 90th $537 to $3,981
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 $537.03 Median $6,456.54 Typical High $14,454.40 | Facility | None | $537.03 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $5,888.44 | Professional | None | $537.03 | $537.03 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $1,905.46 Typical High $4,073.80 | Professional | None | $512.86 | $1,905.46 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $1,202.26 Typical High $2,570.40 | Professional | 62 · Two surgeons | $323.59 | $1,202.26 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $302.00 Typical High $645.65 | Professional | 80 · Assistant surgeon | $83.18 | $302.00 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $269.15 Typical High $562.34 | Professional | AS · PA/NP assist | $72.44 | $269.15 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,905.46 | Facility | None | $645.65 | $1,071.52 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $2,511.89 | Professional | None | $870.96 | $954.99 | $2,511.89 |
DeanCare Setting Facility Modifier None Typical Low $630.96 Median $4,365.16 Typical High $7,762.47 | Facility | None | $630.96 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,584.89 | Professional | None | $954.99 | $1,174.90 | $1,584.89 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $602.56 | $741.31 | $1,000.00 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $151.36 | $186.21 | $257.04 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $223.87 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $3,890.45 | Facility | None | $501.19 | $1,819.70 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,380.38 Typical High $4,265.80 | Professional | None | $562.34 | $1,380.38 | $4,265.80 |
Network Health Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $3,235.94 | Facility | None | $954.99 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,513.56 | Professional | None | $676.08 | $1,122.02 | $1,513.56 |
Prevea360 Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,096.48 | Facility | None | $524.81 | $724.44 | $1,096.48 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $1,318.26 Typical High $2,344.23 | Professional | None | $575.44 | $1,318.26 | $2,344.23 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,288.25 | Facility | None | $645.65 | $831.76 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Security Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,479.11 | $2,454.71 | $3,801.89 |
United Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $3,548.13 | Facility | None | $512.86 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,096.48 Typical High $2,630.27 | Professional | None | $537.03 | $1,096.48 | $2,630.27 |
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 $263.03 Median $263.03 Typical High $2,951.21 | Professional | 52 · Reduced service | $263.03 | $263.03 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $1,174.90 | Professional | 53 · Discontinued | $107.15 | $107.15 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $4,466.84 | Professional | 54 · Surgery only | $398.11 | $398.11 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $891.25 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $588.84 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $4,168.69 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $588.84 Typical High $794.33 | Professional | 51 · Multiple procedures | $478.63 | $588.84 | $794.33 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $933.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $758.58 | $933.25 | $1,288.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $323.59 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $323.59 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $977.24 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $794.33 | $977.24 | $1,348.96 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $151.36 Median $186.21 Typical High $257.04 | Professional | 81 · Minimal assistant surgeon | $151.36 | $186.21 | $257.04 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $151.36 Median $186.21 Typical High $257.04 | Professional | 82 · Assistant surgeon, no resident | $151.36 | $186.21 | $257.04 |
Where Wisconsin sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$1,514
AK $2,239UT $355
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.