How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,000 to $9,120Professionalmedian $1,514 · 10th to 90th $575 to $4,266
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 $575.44 Median $6,456.54 Typical High $14,454.40 | Facility | None | $575.44 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $5,623.41 | Professional | None | $575.44 | $575.44 | $5,623.41 |
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 $549.54 Median $2,041.74 Typical High $4,265.80 | Professional | None | $549.54 | $2,041.74 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $3,090.30 Typical High $6,456.54 | Professional | 50 · Both sides | $831.76 | $3,090.30 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $1,288.25 Typical High $2,691.53 | Professional | 62 · Two surgeons | $346.74 | $1,288.25 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,344.23 Typical High $4,168.69 | Facility | None | $954.99 | $2,344.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,691.53 | Professional | None | $933.25 | $1,023.29 | $2,691.53 |
DeanCare Setting Facility Modifier None Typical Low $676.08 Median $7,943.28 Typical High $14,454.40 | Facility | None | $676.08 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,258.93 | $1,819.70 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | 50 · Both sides | $1,513.56 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $794.33 Typical High $1,122.02 | Professional | 62 · Two surgeons | $645.65 | $794.33 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $8,709.64 | Facility | None | $912.01 | $3,388.44 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,584.89 Typical High $4,365.16 | Professional | None | $602.56 | $1,584.89 | $4,365.16 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $1,737.80 | Professional | None | $724.44 | $1,348.96 | $1,737.80 |
Prevea360 Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $1,174.90 | Facility | None | $562.34 | $724.44 | $1,174.90 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,412.54 Typical High $2,511.89 | Professional | None | $616.60 | $1,412.54 | $2,511.89 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $4,570.88 | Facility | None | $758.58 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,023.29 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,819.70 | $2,884.03 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,174.90 Typical High $2,818.38 | Professional | None | $575.44 | $1,174.90 | $2,818.38 |
14 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 $281.84 Median $281.84 Typical High $2,818.38 | Professional | 52 · Reduced service | $281.84 | $281.84 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $1,148.15 | Professional | 53 · Discontinued | $114.82 | $114.82 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $4,265.80 | Professional | 54 · Surgery only | $426.58 | $426.58 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $851.14 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $562.34 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $3,981.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $630.96 Typical High $891.25 | Professional | 51 · Multiple procedures | $512.86 | $630.96 | $891.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,445.44 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,445.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | 55 · Aftercare only | $204.17 | $251.19 | $363.08 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $851.14 | $1,047.13 | $1,513.56 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $199.53 Typical High $288.40 | Professional | 80 · Assistant surgeon | $162.18 | $199.53 | $288.40 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $162.18 Median $199.53 Typical High $288.40 | Professional | 81 · Minimal assistant surgeon | $162.18 | $199.53 | $288.40 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $162.18 Median $199.53 Typical High $288.40 | Professional | 82 · Assistant surgeon, no resident | $162.18 | $199.53 | $288.40 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $173.78 Typical High $251.19 | Professional | AS · PA/NP assist | $141.25 | $173.78 | $251.19 |
Where Wisconsin sits
The same service costs 8.1 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
$1,995
AK $2,399TX $295
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.