How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,622 to $14,791Professionalmedian $4,169 · 10th to 90th $1,622 to $11,482
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 $1,621.81 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,621.81 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $11,220.18 | Professional | None | $1,621.81 | $1,621.81 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,511.38 Typical High $14,791.08 | Facility | None | $5,128.61 | $8,511.38 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $6,309.57 Typical High $12,022.64 | Professional | None | $1,584.89 | $6,309.57 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $3,890.45 Typical High $7,585.78 | Professional | 62 · Two surgeons | $1,000.00 | $3,890.45 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $1,000.00 Typical High $1,949.84 | Professional | 80 · Assistant surgeon | $251.19 | $1,000.00 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $870.96 Typical High $1,698.24 | Professional | AS · PA/NP assist | $218.78 | $870.96 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,011.87 Typical High $9,332.54 | Facility | None | $1,023.29 | $5,011.87 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $7,943.28 | Professional | None | $2,691.53 | $2,951.21 | $7,943.28 |
DeanCare Setting Facility Modifier None Typical Low $1,819.70 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,819.70 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $5,128.61 | Professional | None | $2,884.03 | $3,548.13 | $5,128.61 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $2,238.72 Typical High $3,235.94 | Professional | 62 · Two surgeons | $1,819.70 | $2,238.72 | $3,235.94 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $562.34 Typical High $812.83 | Professional | 80 · Assistant surgeon | $467.74 | $562.34 | $812.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $501.19 Typical High $724.44 | Professional | AS · PA/NP assist | $407.38 | $501.19 | $724.44 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $7,244.36 Typical High $15,135.61 | Facility | None | $1,258.93 | $7,244.36 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $14,454.40 | Professional | None | $1,659.59 | $4,073.80 | $14,454.40 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $10,715.19 Typical High $17,378.01 | Facility | None | $2,818.38 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $4,677.35 | Professional | None | $2,041.74 | $3,630.78 | $4,677.35 |
Prevea360 Setting Facility Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,548.13 | Facility | None | $1,513.56 | $1,949.84 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $4,466.84 Typical High $7,244.36 | Professional | None | $1,949.84 | $4,466.84 | $7,244.36 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $6,165.95 Typical High $10,232.93 | Facility | None | $812.83 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,951.21 | $2,951.21 | $3,548.13 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $8,709.64 Typical High $11,481.54 | Professional | None | $4,897.79 | $8,709.64 | $11,481.54 |
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 $1,621.81 Median $3,467.37 Typical High $7,943.28 | Professional | None | $1,621.81 | $3,467.37 | $7,943.28 |
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 $812.83 Median $812.83 Typical High $5,623.41 | Professional | 52 · Reduced service | $812.83 | $812.83 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $2,290.87 | Professional | 53 · Discontinued | $323.59 | $323.59 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $8,511.38 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $1,698.24 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $7,943.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,778.28 Typical High $2,570.40 | Professional | 51 · Multiple procedures | $1,445.44 | $1,778.28 | $2,570.40 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,818.38 Typical High $4,073.80 | Professional | 54 · Surgery only | $2,290.87 | $2,818.38 | $4,073.80 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $707.95 Typical High $1,023.29 | Professional | 55 · Aftercare only | $575.44 | $707.95 | $1,023.29 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,951.21 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,951.21 | $4,265.80 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $467.74 Median $562.34 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $467.74 | $562.34 | $812.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $467.74 Median $562.34 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $467.74 | $562.34 | $812.83 |
Where Wisconsin sits
The same service costs 11.2 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
$5,248
AK $7,244TX $646
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.