How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,454Professionalmedian $2,291 · 10th to 90th $1,318 to $8,913
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 $1,318.26 Median $11,220.18 Typical High $14,454.40 | Facility | None | $1,318.26 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $12,302.69 | Professional | None | $1,230.27 | $1,318.26 | $12,302.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $3,890.45 Typical High $9,120.11 | Professional | None | $1,258.93 | $3,890.45 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $5,754.40 Typical High $13,803.84 | Professional | 50 · Both sides | $1,905.46 | $5,754.40 | $13,803.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $2,398.83 Typical High $5,754.40 | Professional | 62 · Two surgeons | $794.33 | $2,398.83 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $616.60 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $204.17 | $616.60 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $4,365.16 Typical High $7,585.78 | Facility | None | $1,862.09 | $4,365.16 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $4,897.79 | Professional | None | $1,513.56 | $1,621.81 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $14,125.38 | Facility | None | $1,288.25 | $7,762.47 | $14,125.38 |
DeanCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,398.83 | $3,801.89 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $3,630.78 Typical High $5,754.40 | Professional | 50 · Both sides | $3,090.30 | $3,630.78 | $5,754.40 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,513.56 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,288.25 | $1,513.56 | $2,398.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $389.05 Typical High $616.60 | Professional | 80 · Assistant surgeon | $331.13 | $389.05 | $616.60 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,230.27 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $4,365.16 Typical High $8,912.51 | Professional | None | $1,479.11 | $4,365.16 | $8,912.51 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,754.23 | $3,548.13 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,398.83 | Facility | None | $933.25 | $1,318.26 | $2,398.83 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,344.23 Typical High $5,011.87 | Professional | None | $1,148.15 | $2,344.23 | $5,011.87 |
Quartz Setting Facility Modifier None Typical Low $1,479.11 Median $5,248.07 Typical High $8,317.64 | Facility | None | $1,479.11 | $5,248.07 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,621.81 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Security Health Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $6,456.54 | Professional | None | $3,467.37 | $5,011.87 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $5,370.32 | Professional | None | $1,230.27 | $2,089.30 | $5,370.32 |
14 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 $616.60 Median $645.65 Typical High $6,165.95 | Professional | 52 · Reduced service | $616.60 | $645.65 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $2,454.71 | Professional | 53 · Discontinued | $245.47 | $263.03 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $9,120.11 | Professional | 54 · Surgery only | $912.01 | $977.24 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $1,862.09 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $8,511.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $524.81 Typical High $1,148.15 | Professional | AS · PA/NP assist | $165.96 | $524.81 | $1,148.15 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,023.29 Median $1,202.26 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $1,023.29 | $1,202.26 | $1,905.46 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,949.84 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,659.59 | $1,949.84 | $3,090.30 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $478.63 Typical High $776.25 | Professional | 55 · Aftercare only | $407.38 | $478.63 | $776.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,041.74 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,041.74 | $3,235.94 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $331.13 Median $389.05 Typical High $616.60 | Professional | 81 · Minimal assistant surgeon | $331.13 | $389.05 | $616.60 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $331.13 Median $389.05 Typical High $616.60 | Professional | 82 · Assistant surgeon, no resident | $331.13 | $389.05 | $616.60 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $338.84 Typical High $537.03 | Professional | AS · PA/NP assist | $288.40 | $338.84 | $537.03 |
Where Wisconsin sits
The same service costs 3.0 times more in Oklahoma than in Montana. 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 $10,899MT $3,640
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.