How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $1,950 · 10th to 90th $1,047 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 $1,047.13 Median $1,047.13 Typical High $14,454.40 | Facility | None | $1,047.13 | $1,047.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $9,332.54 | Professional | None | $1,047.13 | $1,047.13 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $18,620.87 | Facility | None | $6,309.57 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $3,162.28 Typical High $7,413.10 | Professional | None | $1,023.29 | $3,162.28 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,949.84 Typical High $5,011.87 | Professional | 62 · Two surgeons | $645.65 | $1,949.84 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $501.19 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $162.18 | $501.19 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $436.52 Typical High $1,122.02 | Professional | AS · PA/NP assist | $141.25 | $436.52 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $3,801.89 | Facility | None | $812.83 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,981.07 | Professional | None | $1,412.54 | $1,778.28 | $3,981.07 |
DeanCare Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,047.13 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,659.59 | $1,949.84 | $3,311.31 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,230.27 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,047.13 | $1,230.27 | $2,089.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $524.81 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $524.81 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $275.42 Typical High $467.74 | Professional | AS · PA/NP assist | $234.42 | $275.42 | $467.74 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $3,630.78 Typical High $7,244.36 | Professional | None | $1,202.26 | $3,630.78 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $2,089.30 | Facility | None | $1,412.54 | $1,995.26 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,318.26 | $2,238.72 | $2,951.21 |
Prevea360 Setting Facility Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,089.30 | Facility | None | $870.96 | $1,122.02 | $2,089.30 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,071.52 | $2,238.72 | $4,073.80 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,778.28 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Security Health Setting Professional Modifier None Typical Low $3,311.31 Median $4,168.69 Typical High $5,248.07 | Professional | None | $3,311.31 | $4,168.69 | $5,248.07 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $4,365.16 | Professional | None | $1,023.29 | $1,737.80 | $4,365.16 |
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 $524.81 Median $524.81 Typical High $4,677.35 | Professional | 52 · Reduced service | $524.81 | $524.81 | $4,677.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $1,905.46 | Professional | 53 · Discontinued | $208.93 | $208.93 | $1,905.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $7,079.46 | Professional | 54 · Surgery only | $794.33 | $794.33 | $7,079.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $1,412.54 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $1,412.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $933.25 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $933.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $6,606.93 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $6,606.93 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $831.76 Median $977.24 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $831.76 | $977.24 | $1,659.59 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,548.82 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,318.26 | $1,548.82 | $2,630.27 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $389.05 Typical High $660.69 | Professional | 55 · Aftercare only | $331.13 | $389.05 | $660.69 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,621.81 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,621.81 | $2,754.23 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $263.03 Median $309.03 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $263.03 | $309.03 | $524.81 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $263.03 Median $309.03 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $263.03 | $309.03 | $524.81 |
Where Wisconsin sits
The same service costs 24.5 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
$2,188
AK $4,074TX $166
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.