How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $10,965Professionalmedian $2,138 · 10th to 90th $813 to $6,026
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 $812.83 Median $6,456.54 Typical High $14,454.40 | Facility | None | $812.83 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $7,585.78 | Professional | None | $812.83 | $812.83 | $7,585.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $3,235.94 Typical High $6,165.95 | Professional | None | $794.33 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $2,041.74 Typical High $3,890.45 | Professional | 62 · Two surgeons | $501.19 | $2,041.74 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $512.86 Typical High $977.24 | Professional | 80 · Assistant surgeon | $128.82 | $512.86 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $446.68 Typical High $870.96 | Professional | AS · PA/NP assist | $112.20 | $446.68 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $4,168.69 | Facility | None | $954.99 | $2,630.27 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $4,365.16 | Professional | None | $1,348.96 | $1,479.11 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $4,365.16 Typical High $7,762.47 | Facility | None | $933.25 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,819.70 | $2,570.40 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,148.15 Typical High $1,621.81 | Professional | 62 · Two surgeons | $933.25 | $1,148.15 | $1,621.81 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 80 · Assistant surgeon | $234.42 | $288.40 | $416.87 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | AS · PA/NP assist | $204.17 | $251.19 | $363.08 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $5,623.41 Typical High $10,964.78 | Facility | None | $977.24 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,137.96 Typical High $6,309.57 | Professional | None | $870.96 | $2,137.96 | $6,309.57 |
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 $1,047.13 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,862.09 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $1,548.82 | Facility | None | $831.76 | $933.25 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,630.78 | Professional | None | $912.01 | $2,089.30 | $3,630.78 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $4,570.88 | Facility | None | $758.58 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,479.11 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,073.80 Typical High $5,888.44 | Professional | None | $2,511.89 | $4,073.80 | $5,888.44 |
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 $831.76 Median $1,698.24 Typical High $3,981.07 | Professional | None | $831.76 | $1,698.24 | $3,981.07 |
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 $407.38 Median $407.38 Typical High $3,801.89 | Professional | 52 · Reduced service | $407.38 | $407.38 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,513.56 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $5,754.40 | Professional | 54 · Surgery only | $616.60 | $616.60 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $1,148.15 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $758.58 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $5,370.32 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $741.31 | $891.25 | $1,288.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,445.44 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,174.90 | $1,445.44 | $2,089.30 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $363.08 Typical High $512.86 | Professional | 55 · Aftercare only | $295.12 | $363.08 | $512.86 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,513.56 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,513.56 | $2,187.76 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 81 · Minimal assistant surgeon | $234.42 | $288.40 | $416.87 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $288.40 | $416.87 |
Where Wisconsin sits
The same service costs 7.4 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
$2,754
AK $3,467TX $468
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.