How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,445 to $20,417Professionalmedian $2,570 · 10th to 90th $977 to $7,244
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 $977.24 Median $8,511.38 Typical High $14,454.40 | Facility | None | $977.24 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $9,549.93 | Professional | None | $977.24 | $977.24 | $9,549.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $15,848.93 Typical High $23,988.33 | Facility | None | $9,772.37 | $15,848.93 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $3,548.13 Typical High $7,585.78 | Professional | None | $954.99 | $3,548.13 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $5,248.07 Typical High $10,964.78 | Professional | 50 · Both sides | $1,445.44 | $5,248.07 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $562.34 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $151.36 | $562.34 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $489.78 Typical High $1,023.29 | Professional | AS · PA/NP assist | $134.90 | $489.78 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,801.89 Typical High $16,982.44 | Facility | None | $1,348.96 | $3,801.89 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,584.89 | $1,778.28 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,096.48 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,737.80 | $2,137.96 | $3,090.30 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,570.40 Median $3,162.28 Typical High $4,570.88 | Professional | 50 · Both sides | $2,570.40 | $3,162.28 | $4,570.88 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | 80 · Assistant surgeon | $275.42 | $338.84 | $489.78 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $426.58 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $426.58 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,202.26 | $7,943.28 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $7,413.10 | Professional | None | $1,096.48 | $2,691.53 | $7,413.10 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,344.23 | $3,019.95 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,995.26 | Facility | None | $933.25 | $1,096.48 | $1,995.26 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,023.29 | $2,344.23 | $4,265.80 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $11,481.54 Typical High $18,620.87 | Facility | None | $1,071.52 | $11,481.54 | $18,620.87 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,778.28 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,897.79 Typical High $6,918.31 | Professional | None | $3,090.30 | $4,897.79 | $6,918.31 |
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 $1,047.13 Median $2,041.74 Typical High $4,897.79 | Professional | None | $1,047.13 | $2,041.74 | $4,897.79 |
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 $489.78 Median $489.78 Typical High $4,786.30 | Professional | 52 · Reduced service | $489.78 | $489.78 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $1,949.84 | Professional | 53 · Discontinued | $194.98 | $194.98 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $7,244.36 | Professional | 54 · Surgery only | $724.44 | $724.44 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $1,445.44 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $954.99 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $6,760.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | 51 · Multiple procedures | $870.96 | $1,071.52 | $1,548.82 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,698.24 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,380.38 | $1,698.24 | $2,454.71 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | 55 · Aftercare only | $346.74 | $426.58 | $616.60 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,778.28 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,778.28 | $2,570.40 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | 81 · Minimal assistant surgeon | $275.42 | $338.84 | $489.78 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | 82 · Assistant surgeon, no resident | $275.42 | $338.84 | $489.78 |
Where Wisconsin sits
The same service costs 8.5 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
$3,548
AK $4,074TX $479
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.