How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,288 to $15,136Professionalmedian $2,818 · 10th to 90th $1,096 to $8,128
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 $1,096.48 Median $1,096.48 Typical High $14,454.40 | Facility | None | $1,096.48 | $1,096.48 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $10,715.19 | Professional | None | $1,096.48 | $1,096.48 | $10,715.19 |
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 $1,071.52 Median $3,981.07 Typical High $8,317.64 | Professional | None | $1,071.52 | $3,981.07 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $5,888.44 Typical High $12,302.69 | Professional | 50 · Both sides | $1,621.81 | $5,888.44 | $12,302.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $2,511.89 Typical High $5,248.07 | Professional | 62 · Two surgeons | $676.08 | $2,511.89 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $630.96 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $169.82 | $630.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $549.54 Typical High $1,148.15 | Professional | AS · PA/NP assist | $151.36 | $549.54 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,890.45 Typical High $16,982.44 | Facility | None | $1,023.29 | $3,890.45 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $5,128.61 | Professional | None | $1,778.28 | $1,949.84 | $5,128.61 |
DeanCare Setting Facility Modifier None Typical Low $1,230.27 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,230.27 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,398.83 | $3,467.37 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,548.13 Typical High $5,128.61 | Professional | 50 · Both sides | $2,884.03 | $3,548.13 | $5,128.61 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,513.56 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,230.27 | $1,513.56 | $2,137.96 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $380.19 Typical High $549.54 | Professional | 80 · Assistant surgeon | $309.03 | $380.19 | $549.54 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $331.13 Typical High $478.63 | Professional | AS · PA/NP assist | $269.15 | $331.13 | $478.63 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $7,244.36 Typical High $15,135.61 | Facility | None | $1,230.27 | $7,244.36 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $2,884.03 Typical High $8,317.64 | Professional | None | $1,174.90 | $2,884.03 | $8,317.64 |
Network Health Setting Facility Modifier None Typical Low $2,238.72 Median $10,715.19 Typical High $17,378.01 | Facility | None | $2,238.72 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,311.31 | Professional | None | $1,380.38 | $2,630.27 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,290.87 | Facility | None | $1,023.29 | $1,288.25 | $2,290.87 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,630.27 Typical High $4,786.30 | Professional | None | $1,148.15 | $2,630.27 | $4,786.30 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $11,481.54 Typical High $18,620.87 | Facility | None | $812.83 | $11,481.54 | $18,620.87 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,949.84 | $1,949.84 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $5,495.41 Typical High $7,762.47 | Professional | None | $3,019.95 | $5,495.41 | $7,762.47 |
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 $1,122.02 Median $2,238.72 Typical High $5,495.41 | Professional | None | $1,122.02 | $2,238.72 | $5,495.41 |
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 $537.03 Median $537.03 Typical High $5,370.32 | Professional | 52 · Reduced service | $537.03 | $537.03 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $2,187.76 | Professional | 53 · Discontinued | $218.78 | $218.78 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $8,128.31 | Professional | 54 · Surgery only | $812.83 | $812.83 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $1,621.81 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $7,585.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,202.26 Typical High $1,698.24 | Professional | 51 · Multiple procedures | $977.24 | $1,202.26 | $1,698.24 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,905.46 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,548.82 | $1,905.46 | $2,754.23 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $478.63 Typical High $691.83 | Professional | 55 · Aftercare only | $389.05 | $478.63 | $691.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,995.26 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,995.26 | $2,884.03 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $380.19 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $309.03 | $380.19 | $549.54 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $380.19 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $380.19 | $549.54 |
Where Wisconsin sits
The same service costs 8.3 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
$3,715
AK $4,571TX $550
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.