How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,318 to $11,482Professionalmedian $2,042 · 10th to 90th $813 to $6,166
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 $11,220.18 Typical High $14,454.40 | Facility | None | $812.83 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $8,912.51 | Professional | None | $812.83 | $812.83 | $8,912.51 |
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 $1,995.26 Typical High $3,890.45 | Professional | 62 · Two surgeons | $501.19 | $1,995.26 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $512.86 Typical High $977.24 | Professional | 80 · Assistant surgeon | $125.89 | $512.86 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $446.68 Typical High $851.14 | Professional | AS · PA/NP assist | $112.20 | $446.68 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $3,162.28 Typical High $5,495.41 | Facility | None | $1,862.09 | $3,162.28 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $4,265.80 | Professional | None | $1,348.96 | $1,479.11 | $4,265.80 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $7,762.47 Typical High $14,125.38 | Facility | None | $933.25 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,778.28 | $2,570.40 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,122.02 Typical High $1,621.81 | Professional | 62 · Two surgeons | $912.01 | $1,122.02 | $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 $11,481.54 | Facility | None | $977.24 | $5,623.41 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,137.96 Typical High $6,165.95 | Professional | None | $870.96 | $2,137.96 | $6,165.95 |
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 $1,023.29 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,905.46 | $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 $891.25 Median $2,041.74 Typical High $3,630.78 | Professional | None | $891.25 | $2,041.74 | $3,630.78 |
Quartz Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $6,025.60 | Facility | None | $1,479.11 | $3,981.07 | $6,025.60 |
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 $1,819.70 Median $4,073.80 Typical High $5,888.44 | Professional | None | $1,819.70 | $4,073.80 | $5,888.44 |
The Alliance Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $6,606.93 | Professional | None | $2,884.03 | $3,388.44 | $6,606.93 |
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 $4,466.84 | Professional | 52 · Reduced service | $407.38 | $407.38 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $1,778.28 | Professional | 53 · Discontinued | $162.18 | $162.18 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $6,760.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $1,348.96 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $891.25 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $6,309.57 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $891.25 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $724.44 | $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 3.1 times more in Washington, DC than in Kansas. 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
DC $8,178KS $2,615
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.