How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,413 to $18,621Professionalmedian $2,951 · 10th to 90th $1,122 to $8,511
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 $1,122.02 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,122.02 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $11,220.18 | Professional | None | $1,122.02 | $1,122.02 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $14,791.08 Typical High $22,387.21 | Facility | None | $10,964.78 | $14,791.08 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $4,168.69 Typical High $8,912.51 | Professional | None | $1,122.02 | $4,168.69 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $6,165.95 Typical High $12,882.50 | Professional | 50 · Both sides | $1,659.59 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $2,570.40 Typical High $5,370.32 | Professional | 62 · Two surgeons | $707.95 | $2,570.40 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $676.08 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $177.83 | $676.08 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $588.84 Typical High $1,230.27 | Professional | AS · PA/NP assist | $154.88 | $588.84 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,981.07 Typical High $12,882.50 | Facility | None | $1,202.26 | $3,981.07 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $5,370.32 | Professional | None | $1,862.09 | $2,041.74 | $5,370.32 |
DeanCare Setting Facility Modifier None Typical Low $1,258.93 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,258.93 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,715.35 Typical High $5,370.32 | Professional | 50 · Both sides | $3,019.95 | $3,715.35 | $5,370.32 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $398.11 Typical High $562.34 | Professional | 80 · Assistant surgeon | $323.59 | $398.11 | $562.34 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $346.74 Typical High $501.19 | Professional | AS · PA/NP assist | $281.84 | $346.74 | $501.19 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,258.93 | $7,943.28 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $8,709.64 | Professional | None | $1,288.25 | $3,162.28 | $8,709.64 |
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 $1,412.54 Median $2,818.38 Typical High $3,467.37 | Professional | None | $1,412.54 | $2,818.38 | $3,467.37 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,344.23 | Facility | None | $933.25 | $1,258.93 | $2,344.23 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $4,897.79 | Professional | None | $1,174.90 | $2,691.53 | $4,897.79 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $8,511.38 Typical High $14,125.38 | Facility | None | $933.25 | $8,511.38 | $14,125.38 |
Quartz Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,041.74 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $8,128.31 | Professional | None | $3,162.28 | $5,754.40 | $8,128.31 |
The Alliance Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $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 $1,230.27 Median $2,454.71 Typical High $5,623.41 | Professional | None | $1,230.27 | $2,454.71 | $5,623.41 |
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 $562.34 Median $562.34 Typical High $5,623.41 | Professional | 52 · Reduced service | $562.34 | $562.34 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $2,238.72 | Professional | 53 · Discontinued | $223.87 | $223.87 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $8,317.64 | Professional | 54 · Surgery only | $851.14 | $851.14 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $1,698.24 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $7,762.47 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | 51 · Multiple procedures | $1,000.00 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,949.84 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,621.81 | $1,949.84 | $2,818.38 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $489.78 Typical High $707.95 | Professional | 55 · Aftercare only | $398.11 | $489.78 | $707.95 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,089.30 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,089.30 | $2,951.21 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $323.59 Median $398.11 Typical High $562.34 | Professional | 81 · Minimal assistant surgeon | $323.59 | $398.11 | $562.34 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $323.59 Median $398.11 Typical High $562.34 | Professional | 82 · Assistant surgeon, no resident | $323.59 | $398.11 | $562.34 |
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
$4,074
AK $4,786TX $575
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.