How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,349 to $18,621Professionalmedian $3,467 · 10th to 90th $1,349 to $9,772
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 $1,348.96 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,348.96 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $16,595.87 | Professional | None | $1,348.96 | $1,348.96 | $16,595.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $14,454.40 Typical High $22,387.21 | Facility | None | $5,888.44 | $14,454.40 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $5,248.07 Typical High $10,000.00 | Professional | None | $1,318.26 | $5,248.07 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $831.76 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $208.93 | $831.76 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $741.31 Typical High $1,380.38 | Professional | AS · PA/NP assist | $181.97 | $741.31 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,786.30 Typical High $9,332.54 | Facility | None | $954.99 | $4,786.30 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $7,079.46 | Professional | None | $2,187.76 | $2,398.83 | $7,079.46 |
DeanCare Setting Facility Modifier None Typical Low $1,513.56 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,513.56 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,398.83 | $2,951.21 | $4,265.80 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $467.74 Typical High $676.08 | Professional | 80 · Assistant surgeon | $380.19 | $467.74 | $676.08 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $407.38 Typical High $588.84 | Professional | AS · PA/NP assist | $331.13 | $407.38 | $588.84 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $5,623.41 Typical High $13,803.84 | Facility | None | $1,202.26 | $5,623.41 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $10,232.93 | Professional | None | $1,479.11 | $3,548.13 | $10,232.93 |
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 $1,698.24 Median $3,235.94 Typical High $4,073.80 | Professional | None | $1,698.24 | $3,235.94 | $4,073.80 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,691.53 | Facility | None | $933.25 | $1,513.56 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,445.44 Median $3,311.31 Typical High $6,165.95 | Professional | None | $1,445.44 | $3,311.31 | $6,165.95 |
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 $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,398.83 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $3,981.07 Median $7,079.46 Typical High $9,772.37 | Professional | None | $3,981.07 | $7,079.46 | $9,772.37 |
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 $1,380.38 Median $2,818.38 Typical High $6,606.93 | Professional | None | $1,380.38 | $2,818.38 | $6,606.93 |
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 $660.69 Median $660.69 Typical High $8,317.64 | Professional | 52 · Reduced service | $660.69 | $660.69 | $8,317.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $3,311.31 | Professional | 53 · Discontinued | $269.15 | $269.15 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $12,302.69 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $12,302.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $2,454.71 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $2,454.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $1,659.59 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $1,659.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $11,481.54 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $11,481.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,202.26 Median $1,479.11 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,202.26 | $1,479.11 | $2,089.30 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,905.46 | $2,344.23 | $3,388.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $588.84 Typical High $851.14 | Professional | 55 · Aftercare only | $478.63 | $588.84 | $851.14 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,454.71 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,454.71 | $3,548.13 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $467.74 Typical High $676.08 | Professional | 81 · Minimal assistant surgeon | $380.19 | $467.74 | $676.08 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $467.74 Typical High $676.08 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $467.74 | $676.08 |
Where Wisconsin sits
The same service costs 17.0 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
$4,365
AK $5,623TX $331
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.