How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,318 to $18,197Professionalmedian $2,630 · 10th to 90th $1,072 to $7,586
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 $1,071.52 Median $1,071.52 Typical High $14,454.40 | Facility | None | $1,071.52 | $1,071.52 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $13,182.57 | Professional | None | $1,071.52 | $1,071.52 | $13,182.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $14,791.08 Typical High $22,387.21 | Facility | None | $10,964.78 | $14,791.08 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $3,548.13 Typical High $7,943.28 | Professional | None | $1,047.13 | $3,548.13 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $5,248.07 Typical High $12,022.64 | Professional | 50 · Both sides | $1,548.82 | $5,248.07 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $562.34 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $165.96 | $562.34 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $512.86 Typical High $1,122.02 | Professional | AS · PA/NP assist | $144.54 | $512.86 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,801.89 Typical High $11,748.98 | Facility | None | $1,023.29 | $3,801.89 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $5,011.87 | Professional | None | $1,737.80 | $1,949.84 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $1,202.26 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,202.26 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,344.23 | $3,235.94 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $3,548.13 Typical High $4,786.30 | Professional | 50 · Both sides | $2,511.89 | $3,548.13 | $4,786.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $371.54 Typical High $512.86 | Professional | 80 · Assistant surgeon | $269.15 | $371.54 | $512.86 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $331.13 Typical High $446.68 | Professional | AS · PA/NP assist | $234.42 | $331.13 | $446.68 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $7,585.78 Typical High $16,595.87 | Facility | None | $1,202.26 | $7,585.78 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,691.53 Typical High $8,128.31 | Professional | None | $1,148.15 | $2,691.53 | $8,128.31 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $3,235.94 | Professional | None | $1,348.96 | $2,511.89 | $3,235.94 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,187.76 | Facility | None | $851.14 | $1,202.26 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,630.27 Typical High $4,677.35 | Professional | None | $1,148.15 | $2,630.27 | $4,677.35 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $7,762.47 Typical High $12,882.50 | Facility | None | $812.83 | $7,762.47 | $12,882.50 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $5,370.32 Typical High $7,585.78 | Professional | None | $3,019.95 | $5,370.32 | $7,585.78 |
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 $1,047.13 Median $2,238.72 Typical High $5,248.07 | Professional | None | $1,047.13 | $2,238.72 | $5,248.07 |
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 $537.03 Median $537.03 Typical High $6,606.93 | Professional | 52 · Reduced service | $537.03 | $537.03 | $6,606.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $2,630.27 | Professional | 53 · Discontinued | $213.80 | $213.80 | $2,630.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $10,000.00 | Professional | 54 · Surgery only | $794.33 | $794.33 | $10,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $1,995.26 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $1,995.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $1,318.26 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $1,318.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $9,332.54 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $9,332.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,174.90 Typical High $1,621.81 | Professional | 51 · Multiple procedures | $851.14 | $1,174.90 | $1,621.81 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,862.09 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,348.96 | $1,862.09 | $2,570.40 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $467.74 Typical High $645.65 | Professional | 55 · Aftercare only | $338.84 | $467.74 | $645.65 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,949.84 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,949.84 | $2,691.53 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $371.54 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $269.15 | $371.54 | $512.86 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $371.54 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $371.54 | $512.86 |
Where Wisconsin sits
The same service costs 13.8 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
$3,467
AK $4,467TX $324
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.