How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,349 to $13,183Professionalmedian $2,512 · 10th to 90th $1,349 to $10,471
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 $1,348.96 Median $1,348.96 Typical High $14,454.40 | Facility | None | $1,348.96 | $1,348.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $11,748.98 | Professional | None | $1,348.96 | $1,348.96 | $11,748.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $12,882.50 | Facility | None | $5,128.61 | $8,709.64 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $4,073.80 Typical High $9,549.93 | Professional | None | $1,258.93 | $4,073.80 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $2,570.40 Typical High $6,025.60 | Professional | 62 · Two surgeons | $794.33 | $2,570.40 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $645.65 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $199.53 | $645.65 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $562.34 Typical High $1,348.96 | Professional | AS · PA/NP assist | $173.78 | $562.34 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $4,897.79 | Facility | None | $812.83 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,659.59 | $2,290.87 | $5,128.61 |
DeanCare Setting Facility Modifier None Typical Low $1,348.96 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,348.96 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,511.89 | $4,265.80 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,584.89 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,348.96 | $1,584.89 | $2,691.53 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $676.08 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $676.08 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $354.81 Typical High $588.84 | Professional | AS · PA/NP assist | $302.00 | $354.81 | $588.84 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $5,370.32 Typical High $12,882.50 | Facility | None | $1,122.02 | $5,370.32 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $4,677.35 Typical High $11,748.98 | Professional | None | $1,445.44 | $4,677.35 | $11,748.98 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,754.23 | $3,548.13 |
Prevea360 Setting Facility Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,570.40 | Facility | None | $1,122.02 | $1,445.44 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $5,248.07 | Professional | None | $1,348.96 | $2,754.23 | $5,248.07 |
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 $1,737.80 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,737.80 | $2,290.87 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $3,388.44 Median $5,248.07 Typical High $6,760.83 | Professional | None | $3,388.44 | $5,248.07 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,244.36 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,244.36 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $5,623.41 | Professional | None | $1,258.93 | $2,089.30 | $5,623.41 |
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 $676.08 Median $676.08 Typical High $5,888.44 | Professional | 52 · Reduced service | $676.08 | $676.08 | $5,888.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $2,344.23 | Professional | 53 · Discontinued | $269.15 | $269.15 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $8,709.64 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $1,737.80 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $8,128.31 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,258.93 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,071.52 | $1,258.93 | $2,089.30 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,995.26 Typical High $3,388.44 | Professional | 54 · Surgery only | $1,698.24 | $1,995.26 | $3,388.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $501.19 Typical High $851.14 | Professional | 55 · Aftercare only | $426.58 | $501.19 | $851.14 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,089.30 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,089.30 | $3,548.13 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $398.11 Typical High $676.08 | Professional | 81 · Minimal assistant surgeon | $338.84 | $398.11 | $676.08 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $398.11 Typical High $676.08 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $398.11 | $676.08 |
Where Wisconsin sits
The same service costs 26.3 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
$2,818
AK $5,248TX $200
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.