How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,778 to $19,055Professionalmedian $4,786 · 10th to 90th $1,778 to $13,490
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 $1,778.28 Median $9,549.93 Typical High $14,454.40 | Facility | None | $1,778.28 | $9,549.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $17,378.01 | Professional | None | $1,778.28 | $1,778.28 | $17,378.01 |
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 $1,778.28 Median $6,918.31 Typical High $14,125.38 | Professional | None | $1,778.28 | $6,918.31 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $4,365.16 Typical High $8,912.51 | Professional | 62 · Two surgeons | $1,122.02 | $4,365.16 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $1,096.48 Typical High $2,290.87 | Professional | 80 · Assistant surgeon | $281.84 | $1,096.48 | $2,290.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $977.24 Typical High $1,995.26 | Professional | AS · PA/NP assist | $245.47 | $977.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $6,309.57 Typical High $23,988.33 | Facility | None | $1,023.29 | $6,309.57 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $8,912.51 | Professional | None | $3,019.95 | $3,235.94 | $8,912.51 |
DeanCare Setting Facility Modifier None Typical Low $1,995.26 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,995.26 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $5,623.41 | Professional | None | $3,235.94 | $3,890.45 | $5,623.41 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,454.71 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,995.26 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $630.96 Typical High $912.01 | Professional | 80 · Assistant surgeon | $512.86 | $630.96 | $912.01 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | AS · PA/NP assist | $446.68 | $549.54 | $794.33 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $8,511.38 Typical High $19,498.45 | Facility | None | $1,412.54 | $8,511.38 | $19,498.45 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $4,897.79 Typical High $14,125.38 | Professional | None | $2,041.74 | $4,897.79 | $14,125.38 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $2,238.72 Median $4,466.84 Typical High $5,495.41 | Professional | None | $2,238.72 | $4,466.84 | $5,495.41 |
Prevea360 Setting Facility Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $4,073.80 | Facility | None | $1,659.59 | $2,137.96 | $4,073.80 |
Quartz Setting Professional Modifier None Typical Low $2,137.96 Median $4,897.79 Typical High $8,128.31 | Professional | None | $2,137.96 | $4,897.79 | $8,128.31 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $15,848.93 Typical High $26,302.68 | Facility | None | $812.83 | $15,848.93 | $26,302.68 |
Quartz Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,235.94 | $4,365.16 |
Security Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Security Health Setting Professional Modifier None Typical Low $5,495.41 Median $11,481.54 Typical High $12,882.50 | Professional | None | $5,495.41 | $11,481.54 | $12,882.50 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $3,890.45 Typical High $8,912.51 | Professional | None | $1,949.84 | $3,890.45 | $8,912.51 |
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 $891.25 Median $891.25 Typical High $8,709.64 | Professional | 52 · Reduced service | $891.25 | $891.25 | $8,709.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $3,467.37 | Professional | 53 · Discontinued | $354.81 | $354.81 | $3,467.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $12,882.50 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $12,882.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $2,570.40 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $1,737.80 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $1,737.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $12,022.64 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $12,022.64 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,584.89 Median $1,949.84 Typical High $2,818.38 | Professional | 51 · Multiple procedures | $1,584.89 | $1,949.84 | $2,818.38 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $3,162.28 Typical High $4,570.88 | Professional | 54 · Surgery only | $2,570.40 | $3,162.28 | $4,570.88 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $794.33 Typical High $1,122.02 | Professional | 55 · Aftercare only | $645.65 | $794.33 | $1,122.02 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $3,311.31 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $2,691.53 | $3,311.31 | $4,786.30 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $512.86 Median $630.96 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $512.86 | $630.96 | $912.01 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $512.86 Median $630.96 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $512.86 | $630.96 | $912.01 |
Where Wisconsin sits
The same service costs 16.2 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
$5,754
AK $8,128TX $501
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.