How much rates vary
Facilitymedian $5,012 · 10th to 90th $692 to $9,120Professionalmedian $955 · 10th to 90th $447 to $2,570
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 $331.13 Median $467.74 Typical High $14,454.40 | Facility | None | $331.13 | $467.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $3,388.44 | Professional | None | $331.13 | $467.74 | $3,388.44 |
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 $457.09 Median $1,258.93 Typical High $2,570.40 | Professional | None | $457.09 | $1,258.93 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,862.09 Typical High $3,890.45 | Professional | 50 · Both sides | $691.83 | $1,862.09 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $204.17 Typical High $416.87 | Professional | 80 · Assistant surgeon | $72.44 | $204.17 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $177.83 Typical High $363.08 | Professional | AS · PA/NP assist | $64.57 | $177.83 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $3,162.28 | Facility | None | $1,000.00 | $1,819.70 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,949.84 | Professional | None | $562.34 | $831.76 | $1,949.84 |
DeanCare Setting Facility Modifier None Typical Low $398.11 Median $3,162.28 Typical High $5,888.44 | Facility | None | $398.11 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,174.90 | Professional | None | $588.84 | $831.76 | $1,174.90 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,230.27 Typical High $1,778.28 | Professional | 50 · Both sides | $891.25 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $131.83 Typical High $186.21 | Professional | 80 · Assistant surgeon | $95.50 | $131.83 | $186.21 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $114.82 Typical High $165.96 | Professional | AS · PA/NP assist | $83.18 | $114.82 | $165.96 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $8,128.31 | Facility | None | $691.83 | $2,818.38 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,819.70 Typical High $3,548.13 | Professional | None | $562.34 | $1,819.70 | $3,548.13 |
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 $588.84 Median $1,071.52 Typical High $1,445.44 | Professional | None | $588.84 | $1,071.52 | $1,445.44 |
Prevea360 Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $977.24 | Facility | None | $338.84 | $524.81 | $977.24 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $1,096.48 Typical High $2,089.30 | Professional | None | $575.44 | $1,096.48 | $2,089.30 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $3,467.37 | Facility | None | $812.83 | $2,187.76 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,047.13 | Professional | None | $602.56 | $831.76 | $1,047.13 |
Security Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,122.02 | $1,621.81 |
Security Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,412.54 | $2,187.76 | $3,090.30 |
The Alliance Setting Professional Modifier None Typical Low $549.54 Median $1,513.56 Typical High $2,344.23 | Professional | None | $549.54 | $1,513.56 | $2,344.23 |
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 $426.58 Median $794.33 Typical High $2,238.72 | Professional | None | $426.58 | $794.33 | $2,238.72 |
10 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 Facility Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $346.74 | Facility | 54 · Surgery only | $251.19 | $251.19 | $346.74 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $323.59 | Facility | 78 · Unplanned return to OR | $234.42 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $346.74 Typical High $2,691.53 | Professional | 54 · Surgery only | $251.19 | $346.74 | $2,691.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $323.59 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $234.42 | $323.59 | $2,511.89 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $295.12 Median $416.87 Typical High $588.84 | Professional | 51 · Multiple procedures | $295.12 | $416.87 | $588.84 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $660.69 Typical High $933.25 | Professional | 54 · Surgery only | $478.63 | $660.69 | $933.25 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $165.96 Typical High $234.42 | Professional | 55 · Aftercare only | $120.23 | $165.96 | $234.42 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $691.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $501.19 | $691.83 | $977.24 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $131.83 Typical High $186.21 | Professional | 81 · Minimal assistant surgeon | $95.50 | $131.83 | $186.21 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $95.50 Median $131.83 Typical High $186.21 | Professional | 82 · Assistant surgeon, no resident | $95.50 | $131.83 | $186.21 |
Where Wisconsin sits
The same service costs 6.0 times more in Colorado than in West Virginia. 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
CO $6,136WV $1,026
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.