How much rates vary
Facilitymedian $5,248 · 10th to 90th $813 to $16,218Professionalmedian $3,548 · 10th to 90th $1,905 to $13,183
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 $1,905.46 Median $1,905.46 Typical High $14,454.40 | Facility | None | $1,905.46 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $18,620.87 | Professional | None | $1,905.46 | $1,905.46 | $18,620.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,317.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $5,623.41 Typical High $13,489.63 | Professional | None | $1,778.28 | $5,623.41 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $3,467.37 Typical High $7,943.28 | Professional | 62 · Two surgeons | $1,096.48 | $3,467.37 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $891.25 Typical High $2,137.96 | Professional | 80 · Assistant surgeon | $281.84 | $891.25 | $2,137.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $794.33 Typical High $1,862.09 | Professional | AS · PA/NP assist | $245.47 | $794.33 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,466.84 Typical High $6,918.31 | Facility | None | $812.83 | $4,466.84 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $7,244.36 | Professional | None | $2,290.87 | $3,235.94 | $7,244.36 |
DeanCare Setting Facility Modifier None Typical Low $1,905.46 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,905.46 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $5,888.44 | Professional | None | $3,019.95 | $3,548.13 | $5,888.44 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,238.72 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,905.46 | $2,238.72 | $3,715.35 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $562.34 Typical High $954.99 | Professional | 80 · Assistant surgeon | $478.63 | $562.34 | $954.99 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $489.78 Typical High $831.76 | Professional | AS · PA/NP assist | $416.87 | $489.78 | $831.76 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $6,456.54 Typical High $13,182.57 | Professional | None | $2,041.74 | $6,456.54 | $13,182.57 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,548.13 | Facility | None | $2,089.30 | $2,570.40 | $3,548.13 |
Network Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,890.45 Typical High $5,011.87 | Professional | None | $2,398.83 | $3,890.45 | $5,011.87 |
Prevea360 Setting Facility Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,715.35 | Facility | None | $1,584.89 | $1,995.26 | $3,715.35 |
Quartz Setting Professional Modifier None Typical Low $1,862.09 Median $3,890.45 Typical High $7,413.10 | Professional | None | $1,862.09 | $3,890.45 | $7,413.10 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $4,786.30 | Facility | None | $758.58 | $1,071.52 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,454.71 | $3,235.94 | $3,981.07 |
Security Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $7,413.10 Typical High $9,549.93 | Professional | None | $4,466.84 | $7,413.10 | $9,549.93 |
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 $1,778.28 Median $2,951.21 Typical High $7,943.28 | Professional | None | $1,778.28 | $2,951.21 | $7,943.28 |
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 $954.99 Median $954.99 Typical High $9,332.54 | Professional | 52 · Reduced service | $954.99 | $954.99 | $9,332.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $3,715.35 | Professional | 53 · Discontinued | $380.19 | $380.19 | $3,715.35 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $14,125.38 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $14,125.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $2,818.38 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $2,818.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $1,862.09 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $1,862.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $13,182.57 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $13,182.57 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,513.56 Median $1,778.28 Typical High $2,951.21 | Professional | 51 · Multiple procedures | $1,513.56 | $1,778.28 | $2,951.21 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,818.38 Typical High $4,786.30 | Professional | 54 · Surgery only | $2,398.83 | $2,818.38 | $4,786.30 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $707.95 Typical High $1,202.26 | Professional | 55 · Aftercare only | $602.56 | $707.95 | $1,202.26 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,951.21 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,951.21 | $5,011.87 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $562.34 Typical High $954.99 | Professional | 81 · Minimal assistant surgeon | $478.63 | $562.34 | $954.99 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $562.34 Typical High $954.99 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $562.34 | $954.99 |
Where Wisconsin sits
The same service costs 5.4 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· 5th of 51
$3,715
AK $6,310TX $1,175
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.