How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,202 to $12,882Professionalmedian $1,202 · 10th to 90th $676 to $5,248
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 $676.08 Median $8,317.64 Typical High $14,454.40 | Facility | None | $676.08 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $6,025.60 | Professional | None | $630.96 | $676.08 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,818.38 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $2,041.74 Typical High $4,786.30 | Professional | None | $630.96 | $2,041.74 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $1,258.93 Typical High $3,162.28 | Professional | 62 · Two surgeons | $389.05 | $1,258.93 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $323.59 Typical High $794.33 | Professional | 80 · Assistant surgeon | $100.00 | $323.59 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $281.84 Typical High $691.83 | Professional | AS · PA/NP assist | $87.10 | $281.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $3,715.35 | Facility | None | $1,202.26 | $2,137.96 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $2,570.40 | Professional | None | $741.31 | $831.76 | $2,570.40 |
DeanCare Setting Facility Modifier None Typical Low $707.95 Median $5,128.61 Typical High $9,332.54 | Facility | None | $707.95 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,258.93 | $2,041.74 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,288.25 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $323.59 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $323.59 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $281.84 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $281.84 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $13,182.57 | Facility | None | $954.99 | $6,606.93 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $2,290.87 Typical High $5,888.44 | Professional | None | $741.31 | $2,290.87 | $5,888.44 |
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 $831.76 Median $1,445.44 Typical High $1,862.09 | Professional | None | $831.76 | $1,445.44 | $1,862.09 |
Prevea360 Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $1,230.27 | Facility | None | $660.69 | $776.25 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $602.56 Median $1,230.27 Typical High $2,630.27 | Professional | None | $602.56 | $1,230.27 | $2,630.27 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $2,691.53 Typical High $4,265.80 | Facility | None | $933.25 | $2,691.53 | $4,265.80 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,023.29 | Professional | None | $812.83 | $831.76 | $1,023.29 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,691.53 | $3,388.44 |
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 $630.96 Median $1,023.29 Typical High $2,754.23 | Professional | None | $630.96 | $1,023.29 | $2,754.23 |
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 $316.23 Median $338.84 Typical High $3,019.95 | Professional | 52 · Reduced service | $316.23 | $338.84 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $1,202.26 | Professional | 53 · Discontinued | $125.89 | $134.90 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $4,466.84 | Professional | 54 · Surgery only | $478.63 | $501.19 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $891.25 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $602.56 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $4,168.69 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $524.81 Median $616.60 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $524.81 | $616.60 | $1,023.29 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,000.00 Typical High $1,621.81 | Professional | 54 · Surgery only | $851.14 | $1,000.00 | $1,621.81 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $251.19 Typical High $407.38 | Professional | 55 · Aftercare only | $213.80 | $251.19 | $407.38 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,047.13 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $891.25 | $1,047.13 | $1,698.24 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $169.82 Median $199.53 Typical High $323.59 | Professional | 81 · Minimal assistant surgeon | $169.82 | $199.53 | $323.59 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $169.82 Median $199.53 Typical High $323.59 | Professional | 82 · Assistant surgeon, no resident | $169.82 | $199.53 | $323.59 |
Where Wisconsin sits
The same service costs 6.5 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· 3rd of 51
$1,479
AK $2,455TX $380
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.