How much rates vary
Facilitymedian $6,918 · 10th to 90th $813 to $17,783Professionalmedian $6,918 · 10th to 90th $3,715 to $25,704
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 $3,715.35 Median $3,715.35 Typical High $14,454.40 | Facility | None | $3,715.35 | $3,715.35 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $32,359.37 | Professional | None | $3,715.35 | $3,715.35 | $32,359.37 |
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 $3,548.13 Median $11,481.54 Typical High $26,915.35 | Professional | None | $3,548.13 | $11,481.54 | $26,915.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $7,244.36 Typical High $17,782.79 | Professional | 62 · Two surgeons | $2,187.76 | $7,244.36 | $17,782.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $562.34 Median $1,819.70 Typical High $4,570.88 | Professional | 80 · Assistant surgeon | $562.34 | $1,819.70 | $4,570.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $1,584.89 Typical High $3,981.07 | Professional | AS · PA/NP assist | $489.78 | $1,584.89 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $8,709.64 Typical High $13,182.57 | Facility | None | $812.83 | $8,709.64 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $4,365.16 Median $6,309.57 Typical High $14,125.38 | Professional | None | $4,365.16 | $6,309.57 | $14,125.38 |
DeanCare Setting Facility Modifier None Typical Low $3,715.35 Median $7,943.28 Typical High $14,454.40 | Facility | None | $3,715.35 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $5,888.44 Median $6,918.31 Typical High $12,022.64 | Professional | None | $5,888.44 | $6,918.31 | $12,022.64 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $3,715.35 Median $4,365.16 Typical High $7,585.78 | Professional | 62 · Two surgeons | $3,715.35 | $4,365.16 | $7,585.78 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $933.25 Median $1,096.48 Typical High $1,905.46 | Professional | 80 · Assistant surgeon | $933.25 | $1,096.48 | $1,905.46 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $812.83 Median $954.99 Typical High $1,659.59 | Professional | AS · PA/NP assist | $812.83 | $954.99 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $18,197.01 | Facility | None | $436.52 | $2,818.38 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $3,801.89 Median $12,882.50 Typical High $25,703.96 | Professional | None | $3,801.89 | $12,882.50 | $25,703.96 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $5,011.87 Typical High $7,413.10 | Facility | None | $2,089.30 | $5,011.87 | $7,413.10 |
Network Health Setting Professional Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $10,715.19 | Professional | None | $4,677.35 | $8,317.64 | $10,715.19 |
Prevea360 Setting Facility Modifier None Typical Low $2,630.27 Median $3,715.35 Typical High $7,585.78 | Facility | None | $2,630.27 | $3,715.35 | $7,585.78 |
Quartz Setting Professional Modifier None Typical Low $3,715.35 Median $7,585.78 Typical High $14,454.40 | Professional | None | $3,715.35 | $7,585.78 | $14,454.40 |
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 $4,897.79 Median $6,309.57 Typical High $7,943.28 | Professional | None | $4,897.79 | $6,309.57 | $7,943.28 |
Security Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Professional | None | $12,589.25 | $12,589.25 | $12,589.25 |
Security Health Setting Professional Modifier None Typical Low $11,748.98 Median $15,135.61 Typical High $19,054.61 | Professional | None | $11,748.98 | $15,135.61 | $19,054.61 |
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 $3,388.44 Median $5,888.44 Typical High $15,848.93 | Professional | None | $3,388.44 | $5,888.44 | $15,848.93 |
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 $1,862.09 Median $1,862.09 Typical High $16,218.10 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $16,218.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $6,456.54 | Professional | 53 · Discontinued | $741.31 | $741.31 | $6,456.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $24,547.09 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $24,547.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $4,897.79 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $4,897.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $3,235.94 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $3,235.94 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,630.27 Typical High $22,908.68 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,630.27 | $22,908.68 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,951.21 Median $3,467.37 Typical High $6,025.60 | Professional | 51 · Multiple procedures | $2,951.21 | $3,467.37 | $6,025.60 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $4,677.35 Median $5,495.41 Typical High $9,549.93 | Professional | 54 · Surgery only | $4,677.35 | $5,495.41 | $9,549.93 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,174.90 Median $1,380.38 Typical High $2,398.83 | Professional | 55 · Aftercare only | $1,174.90 | $1,380.38 | $2,398.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,897.79 Median $5,754.40 Typical High $10,000.00 | Professional | 78 · Unplanned return to OR | $4,897.79 | $5,754.40 | $10,000.00 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $933.25 Median $1,096.48 Typical High $1,905.46 | Professional | 81 · Minimal assistant surgeon | $933.25 | $1,096.48 | $1,905.46 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $933.25 Median $1,096.48 Typical High $1,905.46 | Professional | 82 · Assistant surgeon, no resident | $933.25 | $1,096.48 | $1,905.46 |
Where Wisconsin sits
The same service costs 21.9 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· 6th of 51
$6,918
AK $12,303TX $562
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.