How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,230 to $14,454Professionalmedian $2,138 · 10th to 90th $813 to $5,888
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 $776.25 Median $776.25 Typical High $14,454.40 | Facility | None | $776.25 | $776.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $8,128.31 | Professional | None | $776.25 | $776.25 | $8,128.31 |
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 $812.83 Median $3,019.95 Typical High $6,309.57 | Professional | None | $812.83 | $3,019.95 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $4,570.88 Typical High $9,549.93 | Professional | 50 · Both sides | $1,230.27 | $4,570.88 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $1,905.46 Typical High $3,981.07 | Professional | 62 · Two surgeons | $512.86 | $1,905.46 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $489.78 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $131.83 | $489.78 | $1,023.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $426.58 Typical High $891.25 | Professional | AS · PA/NP assist | $114.82 | $426.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,630.27 Typical High $4,168.69 | Facility | None | $1,023.29 | $2,630.27 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,412.54 | $3,715.35 |
DeanCare Setting Facility Modifier None Typical Low $870.96 Median $7,943.28 Typical High $14,454.40 | Facility | None | $870.96 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,698.24 | $2,454.71 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,570.40 Typical High $3,715.35 | Professional | 50 · Both sides | $2,089.30 | $2,570.40 | $3,715.35 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | 62 · Two surgeons | $870.96 | $1,071.52 | $1,548.82 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $275.42 | $389.05 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | AS · PA/NP assist | $194.98 | $239.88 | $346.74 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $6,456.54 Typical High $15,135.61 | Facility | None | $977.24 | $6,456.54 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,290.87 Typical High $6,165.95 | Professional | None | $954.99 | $2,290.87 | $6,165.95 |
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 $977.24 Median $2,089.30 Typical High $2,454.71 | Professional | None | $977.24 | $2,089.30 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $724.44 Median $933.25 Typical High $1,778.28 | Facility | None | $724.44 | $933.25 | $1,778.28 |
Quartz Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $3,467.37 | Professional | None | $851.14 | $1,949.84 | $3,467.37 |
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 $1,412.54 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,412.54 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $2,454.71 Median $4,365.16 Typical High $5,888.44 | Professional | None | $2,454.71 | $4,365.16 | $5,888.44 |
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 $891.25 Median $1,778.28 Typical High $4,073.80 | Professional | None | $891.25 | $1,778.28 | $4,073.80 |
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 $389.05 Median $389.05 Typical High $4,073.80 | Professional | 52 · Reduced service | $389.05 | $389.05 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $1,621.81 | Professional | 53 · Discontinued | $154.88 | $154.88 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $6,025.60 | Professional | 54 · Surgery only | $588.84 | $588.84 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $1,202.26 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $812.83 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $5,623.41 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $691.83 Median $851.14 Typical High $1,230.27 | Professional | 51 · Multiple procedures | $691.83 | $851.14 | $1,230.27 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,348.96 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,122.02 | $1,348.96 | $1,949.84 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | 55 · Aftercare only | $275.42 | $338.84 | $489.78 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,445.44 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,445.44 | $2,041.74 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | 81 · Minimal assistant surgeon | $223.87 | $275.42 | $389.05 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $223.87 Median $275.42 Typical High $389.05 | Professional | 82 · Assistant surgeon, no resident | $223.87 | $275.42 | $389.05 |
Where Wisconsin sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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.
Physician feeFacility fee
AL $11,256KY $2,261
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.