How much rates vary
Facilitymedian $6,918 · 10th to 90th $813 to $17,783Professionalmedian $5,495 · 10th to 90th $2,951 to $20,417
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 $2,951.21 Median $2,951.21 Typical High $14,454.40 | Facility | None | $2,951.21 | $2,951.21 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $25,703.96 | Professional | None | $2,951.21 | $2,951.21 | $25,703.96 |
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 $2,754.23 Median $8,912.51 Typical High $20,892.96 | Professional | None | $2,754.23 | $8,912.51 | $20,892.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $5,495.41 Typical High $13,489.63 | Professional | 62 · Two surgeons | $1,737.80 | $5,495.41 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $1,412.54 Typical High $3,467.37 | Professional | 80 · Assistant surgeon | $436.52 | $1,412.54 | $3,467.37 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $1,230.27 Typical High $3,019.95 | Professional | AS · PA/NP assist | $389.05 | $1,230.27 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,918.31 Typical High $10,471.29 | Facility | None | $812.83 | $6,918.31 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $11,220.18 | Professional | None | $3,467.37 | $5,011.87 | $11,220.18 |
DeanCare Setting Facility Modifier None Typical Low $2,951.21 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,951.21 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $4,677.35 Median $5,495.41 Typical High $9,332.54 | Professional | None | $4,677.35 | $5,495.41 | $9,332.54 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $2,951.21 Median $3,467.37 Typical High $5,888.44 | Professional | 62 · Two surgeons | $2,951.21 | $3,467.37 | $5,888.44 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $741.31 Median $870.96 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $741.31 | $870.96 | $1,513.56 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $645.65 Median $758.58 Typical High $1,318.26 | Professional | AS · PA/NP assist | $645.65 | $758.58 | $1,318.26 |
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 $3,090.30 Median $10,232.93 Typical High $20,417.38 | Professional | None | $3,090.30 | $10,232.93 | $20,417.38 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $5,623.41 | Facility | None | $2,089.30 | $3,981.07 | $5,623.41 |
Network Health Setting Professional Modifier None Typical Low $3,715.35 Median $6,309.57 Typical High $8,128.31 | Professional | None | $3,715.35 | $6,309.57 | $8,128.31 |
Prevea360 Setting Facility Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $5,888.44 | Facility | None | $2,398.83 | $2,951.21 | $5,888.44 |
Quartz Setting Professional Modifier None Typical Low $2,951.21 Median $6,165.95 Typical High $11,481.54 | Professional | None | $2,951.21 | $6,165.95 | $11,481.54 |
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 $3,890.45 Median $5,011.87 Typical High $6,165.95 | Professional | None | $3,890.45 | $5,011.87 | $6,165.95 |
Security Health Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Security Health Setting Professional Modifier None Typical Low $8,912.51 Median $11,748.98 Typical High $14,791.08 | Professional | None | $8,912.51 | $11,748.98 | $14,791.08 |
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 $2,691.53 Median $4,677.35 Typical High $12,589.25 | Professional | None | $2,691.53 | $4,677.35 | $12,589.25 |
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 $1,479.11 Median $1,479.11 Typical High $12,882.50 | Professional | 52 · Reduced service | $1,479.11 | $1,479.11 | $12,882.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $5,248.07 | Professional | 53 · Discontinued | $588.84 | $588.84 | $5,248.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $19,498.45 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $19,498.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $446.68 Typical High $3,890.45 | Professional | 55 · Aftercare only | $446.68 | $446.68 | $3,890.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $295.12 Typical High $2,570.40 | Professional | 56 · Pre-op care only | $295.12 | $295.12 | $2,570.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $18,197.01 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $18,197.01 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,344.23 Median $2,754.23 Typical High $4,677.35 | Professional | 51 · Multiple procedures | $2,344.23 | $2,754.23 | $4,677.35 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $3,715.35 Median $4,365.16 Typical High $7,585.78 | Professional | 54 · Surgery only | $3,715.35 | $4,365.16 | $7,585.78 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $933.25 Median $1,096.48 Typical High $1,905.46 | Professional | 55 · Aftercare only | $933.25 | $1,096.48 | $1,905.46 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,890.45 Median $4,570.88 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $3,890.45 | $4,570.88 | $7,943.28 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $741.31 Median $870.96 Typical High $1,513.56 | Professional | 81 · Minimal assistant surgeon | $741.31 | $870.96 | $1,513.56 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $741.31 Median $870.96 Typical High $1,513.56 | Professional | 82 · Assistant surgeon, no resident | $741.31 | $870.96 | $1,513.56 |
Where Wisconsin sits
The same service costs 5.1 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
$5,623
AK $9,772TX $1,905
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.