How much rates vary
Facilitymedian $5,129 · 10th to 90th $871 to $9,120Professionalmedian $1,072 · 10th to 90th $417 to $3,162
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 $416.87 Median $1,905.46 Typical High $14,454.40 | Facility | None | $416.87 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $4,073.80 | Professional | None | $416.87 | $416.87 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,513.56 Typical High $3,162.28 | Professional | None | $398.11 | $1,513.56 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $2,238.72 Typical High $4,677.35 | Professional | 50 · Both sides | $602.56 | $2,238.72 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $933.25 Typical High $1,995.26 | Professional | 62 · Two surgeons | $251.19 | $933.25 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $239.88 Typical High $501.19 | Professional | 80 · Assistant surgeon | $64.57 | $239.88 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $208.93 Typical High $436.52 | Professional | AS · PA/NP assist | $56.23 | $208.93 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $4,168.69 | Facility | None | $707.95 | $1,659.59 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,949.84 | Professional | None | $676.08 | $758.58 | $1,949.84 |
DeanCare Setting Facility Modifier None Typical Low $501.19 Median $2,754.23 Typical High $5,128.61 | Facility | None | $501.19 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | None | $741.31 | $912.01 | $1,318.26 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,380.38 Typical High $1,995.26 | Professional | 50 · Both sides | $1,122.02 | $1,380.38 | $1,995.26 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $575.44 Typical High $831.76 | Professional | 62 · Two surgeons | $467.74 | $575.44 | $831.76 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $147.91 Typical High $208.93 | Professional | 80 · Assistant surgeon | $120.23 | $147.91 | $208.93 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $186.21 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $186.21 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $8,709.64 | Facility | None | $741.31 | $3,388.44 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $1,071.52 Typical High $3,162.28 | Professional | None | $436.52 | $1,071.52 | $3,162.28 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $1,258.93 | Professional | None | $524.81 | $977.24 | $1,258.93 |
Prevea360 Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $933.25 | Facility | None | $416.87 | $537.03 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $1,047.13 Typical High $1,819.70 | Professional | None | $457.09 | $1,047.13 | $1,819.70 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $2,754.23 Typical High $4,570.88 | Facility | None | $630.96 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | None | $758.58 | $758.58 | $977.24 |
Security Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,202.26 | $2,089.30 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $851.14 Typical High $2,041.74 | Professional | None | $416.87 | $851.14 | $2,041.74 |
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 $208.93 Median $208.93 Typical High $2,041.74 | Professional | 52 · Reduced service | $208.93 | $208.93 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $812.83 | Professional | 53 · Discontinued | $83.18 | $83.18 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $3,090.30 | Professional | 54 · Surgery only | $316.23 | $316.23 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $616.60 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $407.38 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $2,884.03 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $371.54 Median $457.09 Typical High $660.69 | Professional | 51 · Multiple procedures | $371.54 | $457.09 | $660.69 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $724.44 Typical High $1,047.13 | Professional | 54 · Surgery only | $602.56 | $724.44 | $1,047.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $181.97 Typical High $263.03 | Professional | 55 · Aftercare only | $147.91 | $181.97 | $263.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $1,096.48 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $120.23 Median $147.91 Typical High $208.93 | Professional | 81 · Minimal assistant surgeon | $120.23 | $147.91 | $208.93 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $120.23 Median $147.91 Typical High $208.93 | Professional | 82 · Assistant surgeon, no resident | $120.23 | $147.91 | $208.93 |
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
$1,479
AK $1,738TX $209
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.