How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,479 to $15,849Professionalmedian $1,514 · 10th to 90th $813 to $6,310
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 $812.83 Median $8,511.38 Typical High $14,454.40 | Facility | None | $812.83 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $7,079.46 | Professional | None | $812.83 | $812.83 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $2,398.83 Typical High $5,754.40 | Professional | None | $741.31 | $2,398.83 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $1,513.56 Typical High $3,630.78 | Professional | 62 · Two surgeons | $467.74 | $1,513.56 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $380.19 Typical High $912.01 | Professional | 80 · Assistant surgeon | $120.23 | $380.19 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $338.84 Typical High $812.83 | Professional | AS · PA/NP assist | $104.71 | $338.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,235.94 Typical High $7,585.78 | Facility | None | $1,348.96 | $3,235.94 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $3,090.30 | Professional | None | $977.24 | $1,380.38 | $3,090.30 |
DeanCare Setting Facility Modifier None Typical Low $812.83 Median $8,128.31 Typical High $14,791.08 | Facility | None | $812.83 | $8,128.31 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,513.56 | $2,511.89 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,584.89 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,584.89 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $407.38 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $407.38 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $354.81 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $8,317.64 Typical High $15,135.61 | Facility | None | $1,230.27 | $8,317.64 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,754.23 Typical High $8,317.64 | Professional | None | $870.96 | $2,754.23 | $8,317.64 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,659.59 | $2,137.96 |
Prevea360 Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,584.89 | Facility | None | $676.08 | $870.96 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $1,659.59 Typical High $3,162.28 | Professional | None | $812.83 | $1,659.59 | $3,162.28 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $5,128.61 Typical High $8,317.64 | Facility | None | $1,071.52 | $5,128.61 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,380.38 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Security Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $4,073.80 | Professional | None | $2,398.83 | $3,162.28 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $3,388.44 | Professional | None | $776.25 | $1,258.93 | $3,388.44 |
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 $407.38 Median $407.38 Typical High $3,548.13 | Professional | 52 · Reduced service | $407.38 | $407.38 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $1,412.54 | Professional | 53 · Discontinued | $162.18 | $162.18 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $5,370.32 | Professional | 54 · Surgery only | $616.60 | $616.60 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $1,071.52 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $707.95 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $5,011.87 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $758.58 Typical High $1,258.93 | Professional | 51 · Multiple procedures | $645.65 | $758.58 | $1,258.93 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,202.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,023.29 | $1,202.26 | $1,995.26 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $501.19 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $501.19 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,258.93 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,258.93 | $2,137.96 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $204.17 Median $239.88 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $204.17 | $239.88 | $407.38 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $204.17 Median $239.88 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $204.17 | $239.88 | $407.38 |
Where Wisconsin sits
The same service costs 25.1 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· 3rd of 51
$1,778
AK $3,090TX $123
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.