How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $2,692 · 10th to 90th $1,479 to $10,000
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 $1,479.11 Median $1,479.11 Typical High $14,454.40 | Facility | None | $1,479.11 | $1,479.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $14,791.08 | Professional | None | $1,479.11 | $1,479.11 | $14,791.08 |
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 $1,380.38 Median $4,365.16 Typical High $10,471.29 | Professional | None | $1,380.38 | $4,365.16 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $2,754.23 Typical High $6,606.93 | Professional | 62 · Two surgeons | $851.14 | $2,754.23 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $691.83 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $218.78 | $691.83 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $616.60 Typical High $1,479.11 | Professional | AS · PA/NP assist | $190.55 | $616.60 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $5,248.07 | Facility | None | $812.83 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,623.41 | Professional | None | $1,698.24 | $2,511.89 | $5,623.41 |
DeanCare Setting Facility Modifier None Typical Low $1,479.11 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,479.11 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,344.23 | $2,754.23 | $4,570.88 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,737.80 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,445.44 | $1,737.80 | $2,884.03 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $436.52 Typical High $741.31 | Professional | 80 · Assistant surgeon | $371.54 | $436.52 | $741.31 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | AS · PA/NP assist | $323.59 | $380.19 | $645.65 |
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 $1,584.89 Median $5,011.87 Typical High $10,000.00 | Professional | None | $1,584.89 | $5,011.87 | $10,000.00 |
Network Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,691.53 | Facility | None | $1,949.84 | $2,089.30 | $2,691.53 |
Network Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,019.95 Typical High $3,890.45 | Professional | None | $1,819.70 | $3,019.95 | $3,890.45 |
Prevea360 Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,884.03 | Facility | None | $1,230.27 | $1,548.82 | $2,884.03 |
Quartz Setting Professional Modifier None Typical Low $1,445.44 Median $3,019.95 Typical High $5,754.40 | Professional | None | $1,445.44 | $3,019.95 | $5,754.40 |
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 $1,905.46 Median $2,511.89 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,511.89 | $3,090.30 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Security Health Setting Professional Modifier None Typical Low $4,365.16 Median $5,754.40 Typical High $7,413.10 | Professional | None | $4,365.16 | $5,754.40 | $7,413.10 |
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 $1,380.38 Median $2,290.87 Typical High $6,165.95 | Professional | None | $1,380.38 | $2,290.87 | $6,165.95 |
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 $741.31 Median $741.31 Typical High $7,413.10 | Professional | 52 · Reduced service | $741.31 | $741.31 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $2,951.21 | Professional | 53 · Discontinued | $295.12 | $295.12 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $10,964.78 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $2,187.76 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $10,232.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $10,232.93 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,148.15 Median $1,380.38 Typical High $2,290.87 | Professional | 51 · Multiple procedures | $1,148.15 | $1,380.38 | $2,290.87 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,187.76 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,862.09 | $2,187.76 | $3,715.35 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $549.54 Typical High $912.01 | Professional | 55 · Aftercare only | $467.74 | $549.54 | $912.01 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,290.87 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,290.87 | $3,890.45 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $371.54 Median $436.52 Typical High $741.31 | Professional | 81 · Minimal assistant surgeon | $371.54 | $436.52 | $741.31 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $371.54 Median $436.52 Typical High $741.31 | Professional | 82 · Assistant surgeon, no resident | $371.54 | $436.52 | $741.31 |
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
$3,020
AK $4,898TX $891
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.