How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,549 to $19,055Professionalmedian $4,169 · 10th to 90th $1,549 to $11,749
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 $1,548.82 Median $1,548.82 Typical High $14,454.40 | Facility | None | $1,548.82 | $1,548.82 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $15,488.17 | Professional | None | $1,548.82 | $1,548.82 | $15,488.17 |
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 $1,548.82 Median $5,754.40 Typical High $12,302.69 | Professional | None | $1,548.82 | $5,754.40 | $12,302.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $3,630.78 Typical High $7,762.47 | Professional | 62 · Two surgeons | $977.24 | $3,630.78 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $912.01 Typical High $1,949.84 | Professional | 80 · Assistant surgeon | $245.47 | $912.01 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $794.33 Typical High $1,698.24 | Professional | AS · PA/NP assist | $218.78 | $794.33 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $23,442.29 | Facility | None | $1,023.29 | $5,495.41 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $7,413.10 | Professional | None | $2,570.40 | $2,818.38 | $7,413.10 |
DeanCare Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,737.80 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $4,897.79 | Professional | None | $2,754.23 | $3,388.44 | $4,897.79 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,137.96 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,737.80 | $2,137.96 | $3,090.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 80 · Assistant surgeon | $446.68 | $549.54 | $794.33 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $478.63 Typical High $691.83 | Professional | AS · PA/NP assist | $389.05 | $478.63 | $691.83 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $8,511.38 Typical High $19,498.45 | Facility | None | $1,412.54 | $8,511.38 | $19,498.45 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $4,265.80 Typical High $14,454.40 | Professional | None | $1,737.80 | $4,265.80 | $14,454.40 |
Network Health Setting Facility Modifier None Typical Low $3,162.28 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,162.28 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $4,786.30 | Professional | None | $1,949.84 | $3,801.89 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,445.44 | $1,862.09 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,760.83 | Professional | None | $1,621.81 | $3,715.35 | $6,760.83 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $15,488.17 Typical High $25,703.96 | Facility | None | $812.83 | $15,488.17 | $25,703.96 |
Quartz Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,818.38 | $2,818.38 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $5,011.87 Median $7,943.28 Typical High $11,220.18 | Professional | None | $5,011.87 | $7,943.28 | $11,220.18 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $3,235.94 Typical High $7,943.28 | Professional | None | $1,659.59 | $3,235.94 | $7,943.28 |
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 $776.25 Median $776.25 Typical High $7,762.47 | Professional | 52 · Reduced service | $776.25 | $776.25 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $3,090.30 | Professional | 53 · Discontinued | $309.03 | $309.03 | $3,090.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $11,481.54 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $11,481.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $2,344.23 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $10,715.19 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,380.38 Median $1,698.24 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $1,380.38 | $1,698.24 | $2,454.71 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,754.23 Typical High $3,890.45 | Professional | 54 · Surgery only | $2,238.72 | $2,754.23 | $3,890.45 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | 55 · Aftercare only | $549.54 | $676.08 | $977.24 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,884.03 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,884.03 | $4,168.69 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $446.68 | $549.54 | $794.33 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $446.68 | $549.54 | $794.33 |
Where Wisconsin sits
The same service costs 20.4 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
$5,129
AK $6,607TX $324
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.