How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,202 to $11,482Professionalmedian $2,512 · 10th to 90th $977 to $7,413
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 $6,456.54 Typical High $14,454.40 | Facility | None | $977.24 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $12,302.69 | Professional | None | $977.24 | $977.24 | $12,302.69 |
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 $954.99 Median $3,548.13 Typical High $7,413.10 | Professional | None | $954.99 | $3,548.13 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $5,370.32 Typical High $10,964.78 | Professional | 50 · Both sides | $1,445.44 | $5,370.32 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $575.44 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $151.36 | $575.44 | $1,174.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $501.19 Typical High $1,023.29 | Professional | AS · PA/NP assist | $134.90 | $501.19 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $9,332.54 | Facility | None | $954.99 | $3,467.37 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $4,677.35 | Professional | None | $1,621.81 | $1,778.28 | $4,677.35 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,096.48 | $4,365.16 | $7,762.47 |
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 $2,630.27 Median $3,235.94 Typical High $4,677.35 | Professional | 50 · Both sides | $2,630.27 | $3,235.94 | $4,677.35 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $346.74 Typical High $501.19 | Professional | 80 · Assistant surgeon | $281.84 | $346.74 | $501.19 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | AS · PA/NP assist | $245.47 | $302.00 | $436.52 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $5,623.41 Typical High $13,803.84 | Facility | None | $1,096.48 | $5,623.41 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $7,413.10 | Professional | None | $1,122.02 | $2,818.38 | $7,413.10 |
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 $1,230.27 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,398.83 | $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 $1,047.13 Median $2,398.83 Typical High $4,265.80 | Professional | None | $1,047.13 | $2,398.83 | $4,265.80 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,232.93 | Facility | None | $758.58 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,778.28 | $1,778.28 | $2,187.76 |
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 $2,344.23 Median $5,011.87 Typical High $7,079.46 | Professional | None | $2,344.23 | $5,011.87 | $7,079.46 |
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 $1,047.13 Median $2,137.96 Typical High $4,897.79 | Professional | None | $1,047.13 | $2,137.96 | $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 $6,165.95 | Professional | 52 · Reduced service | $489.78 | $489.78 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $2,454.71 | Professional | 53 · Discontinued | $194.98 | $194.98 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $9,120.11 | Professional | 54 · Surgery only | $741.31 | $741.31 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $1,819.70 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $8,511.38 |
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 $1,412.54 Median $1,737.80 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,412.54 | $1,737.80 | $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 $1,479.11 Median $1,819.70 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,819.70 | $2,630.27 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $346.74 Typical High $501.19 | Professional | 81 · Minimal assistant surgeon | $281.84 | $346.74 | $501.19 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $346.74 Typical High $501.19 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $346.74 | $501.19 |
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
$3,311
AK $4,169TX $501
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.