How much rates vary
Facilitymedian $6,918 · 10th to 90th $813 to $18,197Professionalmedian $8,710 · 10th to 90th $4,571 to $31,623
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 $4,570.88 Median $4,570.88 Typical High $14,454.40 | Facility | None | $4,570.88 | $4,570.88 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $41,686.94 | Professional | None | $4,570.88 | $4,570.88 | $41,686.94 |
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 $4,365.16 Median $14,125.38 Typical High $33,884.42 | Professional | None | $4,365.16 | $14,125.38 | $33,884.42 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,754.23 Median $8,912.51 Typical High $21,379.62 | Professional | 62 · Two surgeons | $2,754.23 | $8,912.51 | $21,379.62 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $2,238.72 Typical High $5,623.41 | Professional | 80 · Assistant surgeon | $691.83 | $2,238.72 | $5,623.41 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $1,995.26 Typical High $5,011.87 | Professional | AS · PA/NP assist | $602.56 | $1,995.26 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $10,715.19 Typical High $16,595.87 | Facility | None | $812.83 | $10,715.19 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $5,370.32 Median $7,943.28 Typical High $17,378.01 | Professional | None | $5,370.32 | $7,943.28 | $17,378.01 |
DeanCare Setting Facility Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $14,454.40 | Facility | None | $4,570.88 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $7,244.36 Median $8,511.38 Typical High $14,791.08 | Professional | None | $7,244.36 | $8,511.38 | $14,791.08 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $4,570.88 Median $5,370.32 Typical High $9,332.54 | Professional | 62 · Two surgeons | $4,570.88 | $5,370.32 | $9,332.54 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,174.90 Median $1,380.38 Typical High $2,398.83 | Professional | 80 · Assistant surgeon | $1,174.90 | $1,380.38 | $2,398.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $1,023.29 Median $1,202.26 Typical High $2,089.30 | Professional | AS · PA/NP assist | $1,023.29 | $1,202.26 | $2,089.30 |
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 $4,786.30 Median $16,218.10 Typical High $31,622.78 | Professional | None | $4,786.30 | $16,218.10 | $31,622.78 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $6,309.57 Typical High $8,709.64 | Facility | None | $2,089.30 | $6,309.57 | $8,709.64 |
Network Health Setting Professional Modifier None Typical Low $5,888.44 Median $10,232.93 Typical High $13,182.57 | Professional | None | $5,888.44 | $10,232.93 | $13,182.57 |
Prevea360 Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $9,332.54 | Facility | None | $2,691.53 | $4,677.35 | $9,332.54 |
Quartz Setting Professional Modifier None Typical Low $4,677.35 Median $9,549.93 Typical High $17,782.79 | Professional | None | $4,677.35 | $9,549.93 | $17,782.79 |
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 $6,165.95 Median $7,943.28 Typical High $9,772.37 | Professional | None | $6,165.95 | $7,943.28 | $9,772.37 |
Security Health Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
Security Health Setting Professional Modifier None Typical Low $14,791.08 Median $18,620.87 Typical High $23,442.29 | Professional | None | $14,791.08 | $18,620.87 | $23,442.29 |
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 $4,168.69 Median $7,244.36 Typical High $19,498.45 | Professional | None | $4,168.69 | $7,244.36 | $19,498.45 |
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 $2,290.87 Median $2,290.87 Typical High $20,892.96 | Professional | 52 · Reduced service | $2,290.87 | $2,290.87 | $20,892.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $8,317.64 | Professional | 53 · Discontinued | $933.25 | $933.25 | $8,317.64 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,467.37 Typical High $31,622.78 | Professional | 54 · Surgery only | $3,467.37 | $3,467.37 | $31,622.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $691.83 Typical High $6,309.57 | Professional | 55 · Aftercare only | $691.83 | $691.83 | $6,309.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $4,168.69 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $4,168.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,235.94 Typical High $29,512.09 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,235.94 | $29,512.09 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $3,630.78 Median $4,265.80 Typical High $7,413.10 | Professional | 51 · Multiple procedures | $3,630.78 | $4,265.80 | $7,413.10 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $5,754.40 Median $6,918.31 Typical High $11,748.98 | Professional | 54 · Surgery only | $5,754.40 | $6,918.31 | $11,748.98 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,445.44 Median $1,698.24 Typical High $2,951.21 | Professional | 55 · Aftercare only | $1,445.44 | $1,698.24 | $2,951.21 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,165.95 Median $7,244.36 Typical High $12,589.25 | Professional | 78 · Unplanned return to OR | $6,165.95 | $7,244.36 | $12,589.25 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,174.90 Median $1,380.38 Typical High $2,398.83 | Professional | 81 · Minimal assistant surgeon | $1,174.90 | $1,380.38 | $2,398.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,174.90 Median $1,380.38 Typical High $2,398.83 | Professional | 82 · Assistant surgeon, no resident | $1,174.90 | $1,380.38 | $2,398.83 |
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
$8,511
AK $15,136TX $692
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.