How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,288 to $14,454Professionalmedian $2,754 · 10th to 90th $955 to $7,244
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 $954.99 Median $8,317.64 Typical High $14,454.40 | Facility | None | $954.99 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $15,488.17 | Professional | None | $954.99 | $954.99 | $15,488.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,762.47 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,762.47 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $3,630.78 Typical High $7,762.47 | Professional | None | $954.99 | $3,630.78 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $2,238.72 Typical High $4,897.79 | Professional | 62 · Two surgeons | $602.56 | $2,238.72 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $575.44 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $154.88 | $575.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $501.19 Typical High $1,071.52 | Professional | AS · PA/NP assist | $134.90 | $501.19 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $11,748.98 | Facility | None | $1,023.29 | $3,311.31 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,584.89 | $1,737.80 | $4,466.84 |
DeanCare Setting Facility Modifier None Typical Low $1,071.52 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,071.52 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,089.30 | $3,019.95 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,071.52 | $1,318.26 | $1,905.46 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | 80 · Assistant surgeon | $269.15 | $331.13 | $478.63 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $416.87 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $7,244.36 Typical High $15,135.61 | Facility | None | $1,071.52 | $7,244.36 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $11,481.54 | Professional | None | $1,148.15 | $2,754.23 | $11,481.54 |
Network Health Setting Facility Modifier None Typical Low $2,398.83 Median $10,715.19 Typical High $17,378.01 | Facility | None | $2,398.83 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $3,019.95 | Professional | None | $1,202.26 | $2,818.38 | $3,019.95 |
Prevea360 Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,137.96 | Facility | None | $891.25 | $1,148.15 | $2,137.96 |
Quartz Setting Professional Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,096.48 | $2,511.89 | $4,168.69 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $7,762.47 Typical High $12,882.50 | Facility | None | $812.83 | $7,762.47 | $12,882.50 |
Quartz Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,737.80 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $6,025.60 Typical High $6,918.31 | Professional | None | $3,235.94 | $6,025.60 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $4,897.79 | Professional | None | $1,071.52 | $2,089.30 | $4,897.79 |
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 $478.63 Median $478.63 Typical High $7,762.47 | Professional | 52 · Reduced service | $478.63 | $478.63 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $3,090.30 | Professional | 53 · Discontinued | $190.55 | $190.55 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $11,748.98 | Professional | 54 · Surgery only | $707.95 | $707.95 | $11,748.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $2,344.23 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $10,964.78 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $10,964.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $851.14 | $1,047.13 | $1,513.56 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,348.96 | $1,659.59 | $2,398.83 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $416.87 Typical High $602.56 | Professional | 55 · Aftercare only | $338.84 | $416.87 | $602.56 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,737.80 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,737.80 | $2,511.89 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $269.15 | $331.13 | $478.63 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $331.13 | $478.63 |
Where Wisconsin sits
The same service costs 14.8 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
$3,388
AK $4,169TX $282
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.