How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $11,220Professionalmedian $1,698 · 10th to 90th $661 to $5,012
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 $660.69 Median $8,317.64 Typical High $14,454.40 | Facility | None | $660.69 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $7,943.28 | Professional | None | $660.69 | $660.69 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $2,398.83 Typical High $5,011.87 | Professional | None | $645.65 | $2,398.83 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $3,548.13 Typical High $7,413.10 | Professional | 50 · Both sides | $954.99 | $3,548.13 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $1,513.56 Typical High $3,162.28 | Professional | 62 · Two surgeons | $407.38 | $1,513.56 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $4,168.69 | Facility | None | $1,202.26 | $2,398.83 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,202.26 | $3,090.30 |
DeanCare Setting Facility Modifier None Typical Low $794.33 Median $5,128.61 Typical High $9,332.54 | Facility | None | $794.33 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,445.44 | $2,089.30 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,187.76 Typical High $3,162.28 | Professional | 50 · Both sides | $1,778.28 | $2,187.76 | $3,162.28 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $933.25 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,778.28 Typical High $5,011.87 | Professional | None | $724.44 | $1,778.28 | $5,011.87 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $831.76 Median $1,584.89 Typical High $2,041.74 | Professional | None | $831.76 | $1,584.89 | $2,041.74 |
Prevea360 Setting Facility Modifier None Typical Low $660.69 Median $912.01 Typical High $1,348.96 | Facility | None | $660.69 | $912.01 | $1,348.96 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,884.03 | Professional | None | $691.83 | $1,584.89 | $2,884.03 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $3,019.95 Typical High $4,570.88 | Facility | None | $933.25 | $3,019.95 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,202.26 | $1,548.82 |
Security Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,311.31 | $4,677.35 |
The Alliance Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,380.38 Typical High $3,235.94 | Professional | None | $691.83 | $1,380.38 | $3,235.94 |
14 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 $331.13 Median $331.13 Typical High $3,981.07 | Professional | 52 · Reduced service | $331.13 | $331.13 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,584.89 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $5,888.44 | Professional | 54 · Surgery only | $501.19 | $501.19 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $1,174.90 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $794.33 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $5,495.41 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $588.84 Median $724.44 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $588.84 | $724.44 | $1,047.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,659.59 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,659.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $416.87 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $234.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $190.55 | $234.42 | $338.84 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $190.55 Median $234.42 Typical High $338.84 | Professional | 81 · Minimal assistant surgeon | $190.55 | $234.42 | $338.84 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $190.55 Median $234.42 Typical High $338.84 | Professional | 82 · Assistant surgeon, no resident | $190.55 | $234.42 | $338.84 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $204.17 Typical High $295.12 | Professional | AS · PA/NP assist | $165.96 | $204.17 | $295.12 |
Where Wisconsin sits
The same service costs 3.6 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $7,724MT $2,143
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.