How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,479 to $11,220Professionalmedian $3,890 · 10th to 90th $1,479 to $11,220
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 $1,479.11 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,479.11 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $16,982.44 | Professional | None | $1,479.11 | $1,479.11 | $16,982.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,762.47 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,762.47 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $5,495.41 Typical High $11,220.18 | Professional | None | $1,479.11 | $5,495.41 | $11,220.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $8,128.31 Typical High $16,982.44 | Professional | 50 · Both sides | $2,238.72 | $8,128.31 | $16,982.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $870.96 Typical High $1,819.70 | Professional | 80 · Assistant surgeon | $234.42 | $870.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $758.58 Typical High $1,584.89 | Professional | AS · PA/NP assist | $208.93 | $758.58 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,981.07 Typical High $6,025.60 | Facility | None | $1,023.29 | $3,981.07 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $6,918.31 | Professional | None | $2,454.71 | $2,691.53 | $6,918.31 |
DeanCare Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,677.35 | Professional | None | $2,630.27 | $3,235.94 | $4,677.35 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $4,897.79 Typical High $7,079.46 | Professional | 50 · Both sides | $3,981.07 | $4,897.79 | $7,079.46 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $524.81 Typical High $741.31 | Professional | 80 · Assistant surgeon | $426.58 | $524.81 | $741.31 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $457.09 Typical High $660.69 | Professional | AS · PA/NP assist | $371.54 | $457.09 | $660.69 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $4,073.80 Typical High $10,964.78 | Facility | None | $1,148.15 | $4,073.80 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $4,168.69 Typical High $11,220.18 | Professional | None | $1,698.24 | $4,168.69 | $11,220.18 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,862.09 Median $3,630.78 Typical High $4,570.88 | Professional | None | $1,862.09 | $3,630.78 | $4,570.88 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,380.38 | $1,778.28 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $1,548.82 Median $3,548.13 Typical High $6,456.54 | Professional | None | $1,548.82 | $3,548.13 | $6,456.54 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $5,754.40 | Facility | None | $812.83 | $3,467.37 | $5,754.40 |
Quartz Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,691.53 | $3,467.37 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $10,715.19 | Professional | None | $4,897.79 | $7,585.78 | $10,715.19 |
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 $1,621.81 Median $3,090.30 Typical High $7,413.10 | Professional | None | $1,621.81 | $3,090.30 | $7,413.10 |
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 $741.31 Median $741.31 Typical High $8,511.38 | Professional | 52 · Reduced service | $741.31 | $741.31 | $8,511.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $3,388.44 | Professional | 53 · Discontinued | $295.12 | $295.12 | $3,388.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $12,589.25 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $12,589.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $2,570.40 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $1,698.24 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $1,698.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $11,748.98 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $11,748.98 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,621.81 Typical High $2,344.23 | Professional | 51 · Multiple procedures | $1,318.26 | $1,621.81 | $2,344.23 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,570.40 Typical High $3,715.35 | Professional | 54 · Surgery only | $2,137.96 | $2,570.40 | $3,715.35 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $645.65 Typical High $933.25 | Professional | 55 · Aftercare only | $524.81 | $645.65 | $933.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,754.23 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,754.23 | $3,890.45 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $426.58 Median $524.81 Typical High $741.31 | Professional | 81 · Minimal assistant surgeon | $426.58 | $524.81 | $741.31 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $426.58 Median $524.81 Typical High $741.31 | Professional | 82 · Assistant surgeon, no resident | $426.58 | $524.81 | $741.31 |
Where Wisconsin sits
The same service costs 16.2 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
$4,571
AK $6,310TX $389
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.