How much rates vary
Facilitymedian $2,818 · 10th to 90th $759 to $6,166Professionalmedian $1,122 · 10th to 90th $603 to $4,169
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 $602.56 Median $602.56 Typical High $14,454.40 | Facility | None | $602.56 | $602.56 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $4,677.35 | Professional | None | $602.56 | $602.56 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $6,165.95 | Facility | None | $1,202.26 | $3,467.37 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $1,778.28 Typical High $4,168.69 | Professional | None | $549.54 | $1,778.28 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $1,148.15 Typical High $2,630.27 | Professional | 62 · Two surgeons | $354.81 | $1,148.15 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $281.84 Typical High $660.69 | Professional | 80 · Assistant surgeon | $87.10 | $281.84 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $245.47 Typical High $575.44 | Professional | AS · PA/NP assist | $75.86 | $245.47 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $1,995.26 | Facility | None | $758.58 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,290.87 | Professional | None | $724.44 | $1,023.29 | $2,290.87 |
DeanCare Setting Facility Modifier None Typical Low $602.56 Median $7,943.28 Typical High $14,454.40 | Facility | None | $602.56 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,819.70 | Professional | None | $954.99 | $1,122.02 | $1,819.70 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $1,148.15 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $1,148.15 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $295.12 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $295.12 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $257.04 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $257.04 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $4,570.88 | Facility | None | $602.56 | $2,398.83 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $2,041.74 Typical High $4,168.69 | Professional | None | $645.65 | $2,041.74 | $4,168.69 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,584.89 | Professional | None | $758.58 | $1,230.27 | $1,584.89 |
Prevea360 Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $1,148.15 | Facility | None | $501.19 | $645.65 | $1,148.15 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $2,344.23 | Professional | None | $616.60 | $1,258.93 | $2,344.23 |
Quartz Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $1,905.46 | Facility | None | $676.08 | $1,230.27 | $1,905.46 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,258.93 | Professional | None | $758.58 | $1,023.29 | $1,258.93 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,290.87 | $3,019.95 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $562.34 Median $933.25 Typical High $2,454.71 | Professional | None | $562.34 | $933.25 | $2,454.71 |
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 $302.00 Median $302.00 Typical High $2,344.23 | Professional | 52 · Reduced service | $302.00 | $302.00 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $954.99 | Professional | 53 · Discontinued | $120.23 | $120.23 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $3,548.13 | Professional | 54 · Surgery only | $457.09 | $457.09 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $707.95 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $467.74 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $3,311.31 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $562.34 Typical High $912.01 | Professional | 51 · Multiple procedures | $478.63 | $562.34 | $912.01 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $912.01 Typical High $1,479.11 | Professional | 54 · Surgery only | $758.58 | $912.01 | $1,479.11 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $223.87 Typical High $363.08 | Professional | 55 · Aftercare only | $190.55 | $223.87 | $363.08 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $1,548.82 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $154.88 Median $181.97 Typical High $295.12 | Professional | 81 · Minimal assistant surgeon | $154.88 | $181.97 | $295.12 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $154.88 Median $181.97 Typical High $295.12 | Professional | 82 · Assistant surgeon, no resident | $154.88 | $181.97 | $295.12 |
Where Wisconsin sits
The same service costs 5.5 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· 4th of 51
$1,230
AK $2,188TX $398
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.