How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,445 to $21,380Professionalmedian $2,692 · 10th to 90th $1,023 to $7,762
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 $1,023.29 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,023.29 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $10,232.93 | Professional | None | $1,023.29 | $1,023.29 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $15,848.93 Typical High $23,988.33 | Facility | None | $11,220.18 | $15,848.93 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $8,128.31 | Professional | None | $1,000.00 | $3,801.89 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $5,623.41 Typical High $11,748.98 | Professional | 50 · Both sides | $1,513.56 | $5,623.41 | $11,748.98 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $588.84 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $162.18 | $588.84 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $524.81 Typical High $1,096.48 | Professional | AS · PA/NP assist | $141.25 | $524.81 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,801.89 Typical High $23,988.33 | Facility | None | $1,348.96 | $3,801.89 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $4,897.79 | Professional | None | $1,698.24 | $1,862.09 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $1,148.15 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,148.15 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,238.72 | $3,235.94 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,388.44 Typical High $4,897.79 | Professional | 50 · Both sides | $2,754.23 | $3,388.44 | $4,897.79 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $363.08 Typical High $512.86 | Professional | 80 · Assistant surgeon | $295.12 | $363.08 | $512.86 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $316.23 Typical High $457.09 | Professional | AS · PA/NP assist | $257.04 | $316.23 | $457.09 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,148.15 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $7,762.47 | Professional | None | $1,122.02 | $2,818.38 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $3,162.28 | Professional | None | $1,288.25 | $2,511.89 | $3,162.28 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,148.15 Typical High $2,137.96 | Facility | None | $933.25 | $1,148.15 | $2,137.96 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,071.52 | $2,511.89 | $4,466.84 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $16,218.10 Typical High $26,302.68 | Facility | None | $1,071.52 | $16,218.10 | $26,302.68 |
Quartz Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,862.09 | $1,862.09 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Security Health Setting Professional Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $7,244.36 | Professional | None | $3,388.44 | $5,248.07 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $5,128.61 | Professional | None | $1,096.48 | $2,137.96 | $5,128.61 |
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 $512.86 Median $512.86 Typical High $5,128.61 | Professional | 52 · Reduced service | $512.86 | $512.86 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $2,041.74 | Professional | 53 · Discontinued | $204.17 | $204.17 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $7,585.78 | Professional | 54 · Surgery only | $776.25 | $776.25 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $1,513.56 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $7,079.46 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $912.01 Median $1,122.02 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $912.01 | $1,122.02 | $1,621.81 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,778.28 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,479.11 | $1,778.28 | $2,570.40 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $446.68 Typical High $645.65 | Professional | 55 · Aftercare only | $363.08 | $446.68 | $645.65 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,905.46 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,905.46 | $2,691.53 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $363.08 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $295.12 | $363.08 | $512.86 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $363.08 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $363.08 | $512.86 |
Where Wisconsin sits
The same service costs 7.9 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
$3,631
AK $4,365TX $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.