How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,288 to $14,454Professionalmedian $2,512 · 10th to 90th $1,000 to $7,244
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 $1,000.00 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,000.00 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $11,481.54 | Professional | None | $1,000.00 | $1,000.00 | $11,481.54 |
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 $977.24 Median $3,467.37 Typical High $7,585.78 | Professional | None | $977.24 | $3,467.37 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $5,128.61 Typical High $11,220.18 | Professional | 50 · Both sides | $1,479.11 | $5,128.61 | $11,220.18 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $2,137.96 Typical High $4,786.30 | Professional | 62 · Two surgeons | $616.60 | $2,137.96 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $549.54 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $154.88 | $549.54 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $478.63 Typical High $1,047.13 | Professional | AS · PA/NP assist | $138.04 | $478.63 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,019.95 Typical High $4,570.88 | Facility | None | $1,023.29 | $3,019.95 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $4,786.30 | Professional | None | $1,659.59 | $1,819.70 | $4,786.30 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,122.02 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,778.28 | $2,187.76 | $3,162.28 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $3,311.31 Typical High $4,786.30 | Professional | 50 · Both sides | $2,691.53 | $3,311.31 | $4,786.30 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,380.38 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,122.02 | $1,380.38 | $1,995.26 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $512.86 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | AS · PA/NP assist | $251.19 | $309.03 | $446.68 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $6,456.54 Typical High $15,135.61 | Facility | None | $1,122.02 | $6,456.54 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $8,511.38 | Professional | None | $1,096.48 | $2,691.53 | $8,511.38 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $10,715.19 Typical High $17,378.01 | Facility | None | $2,089.30 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,398.83 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,398.83 | $3,090.30 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,089.30 | Facility | None | $933.25 | $1,202.26 | $2,089.30 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,071.52 | $2,454.71 | $4,365.16 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,754.23 Typical High $4,570.88 | Facility | None | $812.83 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $5,128.61 Typical High $7,244.36 | Professional | None | $2,884.03 | $5,128.61 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $2,089.30 Typical High $5,011.87 | Professional | None | $1,023.29 | $2,089.30 | $5,011.87 |
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 $501.19 Median $501.19 Typical High $5,754.40 | Professional | 52 · Reduced service | $501.19 | $501.19 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $2,290.87 | Professional | 53 · Discontinued | $199.53 | $199.53 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $8,511.38 | Professional | 54 · Surgery only | $758.58 | $758.58 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $1,698.24 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $7,943.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $891.25 | $1,096.48 | $1,584.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,778.28 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,445.44 | $1,778.28 | $2,511.89 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $436.52 Typical High $630.96 | Professional | 55 · Aftercare only | $354.81 | $436.52 | $630.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $288.40 | $354.81 | $512.86 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $354.81 | $512.86 |
Where Wisconsin sits
The same service costs 18.2 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
$3,236
AK $4,266TX $234
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.