How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,479 to $19,055Professionalmedian $2,754 · 10th to 90th $891 to $6,761
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 $891.25 Median $6,456.54 Typical High $14,454.40 | Facility | None | $891.25 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $8,912.51 | Professional | None | $891.25 | $891.25 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $14,454.40 Typical High $22,387.21 | Facility | None | $9,772.37 | $14,454.40 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $3,311.31 Typical High $6,918.31 | Professional | None | $870.96 | $3,311.31 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $4,786.30 Typical High $10,232.93 | Professional | 50 · Both sides | $1,318.26 | $4,786.30 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $512.86 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $138.04 | $512.86 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $446.68 Typical High $954.99 | Professional | AS · PA/NP assist | $123.03 | $446.68 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $4,073.80 | Facility | None | $2,398.83 | $2,691.53 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $4,168.69 | Professional | None | $1,513.56 | $3,715.35 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,000.00 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,949.84 | $2,818.38 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,951.21 Typical High $4,265.80 | Professional | 50 · Both sides | $2,398.83 | $2,951.21 | $4,265.80 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $446.68 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $446.68 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $275.42 Typical High $398.11 | Professional | AS · PA/NP assist | $223.87 | $275.42 | $398.11 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,023.29 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $2,454.71 Typical High $6,760.83 | Professional | None | $977.24 | $2,454.71 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,122.02 | $2,137.96 | $2,754.23 |
Prevea360 Setting Facility Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,819.70 | Facility | None | $891.25 | $1,000.00 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $2,187.76 Typical High $3,890.45 | Professional | None | $954.99 | $2,187.76 | $3,890.45 |
Security Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,570.88 Typical High $6,309.57 | Professional | None | $2,884.03 | $4,570.88 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,862.09 Typical High $4,466.84 | Professional | None | $933.25 | $1,862.09 | $4,466.84 |
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 $446.68 Median $446.68 Typical High $4,466.84 | Professional | 52 · Reduced service | $446.68 | $446.68 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $1,778.28 | Professional | 53 · Discontinued | $177.83 | $177.83 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $6,606.93 | Professional | 54 · Surgery only | $676.08 | $676.08 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $1,318.26 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $891.25 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $6,165.95 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $794.33 Median $977.24 Typical High $1,412.54 | Professional | 51 · Multiple procedures | $794.33 | $977.24 | $1,412.54 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $389.05 Typical High $562.34 | Professional | 55 · Aftercare only | $316.23 | $389.05 | $562.34 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,621.81 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,621.81 | $2,344.23 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $257.04 Median $309.03 Typical High $446.68 | Professional | 81 · Minimal assistant surgeon | $257.04 | $309.03 | $446.68 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $257.04 Median $309.03 Typical High $446.68 | Professional | 82 · Assistant surgeon, no resident | $257.04 | $309.03 | $446.68 |
Where Wisconsin sits
The same service costs 17.4 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
$3,388
AK $3,715TX $214
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.