How much rates vary
Facilitymedian $10,715 · 10th to 90th $1,288 to $19,953Professionalmedian $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 $977.24 Median $6,456.54 Typical High $14,454.40 | Facility | None | $977.24 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $10,964.78 | Professional | None | $977.24 | $977.24 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $14,125.38 Typical High $23,988.33 | Facility | None | $6,606.93 | $14,125.38 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $7,762.47 | Professional | None | $1,000.00 | $3,715.35 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $5,495.41 Typical High $11,220.18 | Professional | 50 · Both sides | $1,479.11 | $5,495.41 | $11,220.18 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $2,344.23 Typical High $4,786.30 | Professional | 62 · Two surgeons | $630.96 | $2,344.23 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $588.84 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $158.49 | $588.84 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $512.86 Typical High $1,023.29 | Professional | AS · PA/NP assist | $138.04 | $512.86 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $12,882.50 | Facility | None | $954.99 | $3,467.37 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,621.81 | $1,778.28 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $6,606.93 Typical High $12,022.64 | Facility | None | $1,096.48 | $6,606.93 | $12,022.64 |
DeanCare Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,513.56 | $2,137.96 | $2,951.21 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,162.28 Typical High $4,365.16 | Professional | 50 · Both sides | $2,290.87 | $3,162.28 | $4,365.16 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,348.96 Typical High $1,819.70 | Professional | 62 · Two surgeons | $954.99 | $1,348.96 | $1,819.70 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $338.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $245.47 | $338.84 | $467.74 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $295.12 Typical High $407.38 | Professional | AS · PA/NP assist | $213.80 | $295.12 | $407.38 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,202.26 | $7,943.28 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $7,413.10 | Professional | None | $1,122.02 | $2,884.03 | $7,413.10 |
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 $1,230.27 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,454.71 | $3,019.95 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,995.26 | Facility | None | $933.25 | $1,096.48 | $1,995.26 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,023.29 | $2,344.23 | $4,265.80 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $8,511.38 Typical High $14,125.38 | Facility | None | $758.58 | $8,511.38 | $14,125.38 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,778.28 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $1,698.24 Median $5,248.07 Typical High $7,079.46 | Professional | None | $1,698.24 | $5,248.07 | $7,079.46 |
The Alliance Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $10,232.93 | Professional | None | $4,365.16 | $4,365.16 | $10,232.93 |
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 $1,071.52 Median $2,089.30 Typical High $5,011.87 | Professional | None | $1,071.52 | $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 $489.78 Median $489.78 Typical High $5,495.41 | Professional | 52 · Reduced service | $489.78 | $489.78 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $2,187.76 | Professional | 53 · Discontinued | $194.98 | $194.98 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $8,128.31 | Professional | 54 · Surgery only | $724.44 | $724.44 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $1,621.81 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $7,585.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $758.58 Median $1,071.52 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $758.58 | $1,071.52 | $1,445.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,698.24 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,230.27 | $1,698.24 | $2,344.23 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $426.58 Typical High $588.84 | Professional | 55 · Aftercare only | $309.03 | $426.58 | $588.84 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,778.28 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,778.28 | $2,454.71 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $338.84 Typical High $467.74 | Professional | 81 · Minimal assistant surgeon | $245.47 | $338.84 | $467.74 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $338.84 Typical High $467.74 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $338.84 | $467.74 |
Where Wisconsin sits
The same service costs 5.3 times more in Oklahoma than in Hawaii. 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
OK $14,385HI $2,704
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.