How much rates vary
Facilitymedian $5,248 · 10th to 90th $813 to $16,218Professionalmedian $3,311 · 10th to 90th $1,778 to $12,303
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 $1,778.28 Median $1,778.28 Typical High $14,454.40 | Facility | None | $1,778.28 | $1,778.28 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $19,952.62 | Professional | None | $1,778.28 | $1,778.28 | $19,952.62 |
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 $1,698.24 Median $5,370.32 Typical High $12,882.50 | Professional | None | $1,698.24 | $5,370.32 | $12,882.50 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $3,388.44 Typical High $8,128.31 | Professional | 62 · Two surgeons | $1,047.13 | $3,388.44 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $851.14 Typical High $2,041.74 | Professional | 80 · Assistant surgeon | $263.03 | $851.14 | $2,041.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $741.31 Typical High $1,778.28 | Professional | AS · PA/NP assist | $234.42 | $741.31 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $6,456.54 | Facility | None | $812.83 | $4,168.69 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $6,760.83 | Professional | None | $2,089.30 | $3,090.30 | $6,760.83 |
DeanCare Setting Facility Modifier None Typical Low $1,778.28 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,778.28 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $5,623.41 | Professional | None | $2,818.38 | $3,311.31 | $5,623.41 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $2,089.30 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,778.28 | $2,089.30 | $3,548.13 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 80 · Assistant surgeon | $457.09 | $537.03 | $912.01 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $467.74 Typical High $794.33 | Professional | AS · PA/NP assist | $398.11 | $467.74 | $794.33 |
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 $1,949.84 Median $6,165.95 Typical High $12,302.69 | Professional | None | $1,949.84 | $6,165.95 | $12,302.69 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $3,311.31 | Facility | None | $2,089.30 | $2,398.83 | $3,311.31 |
Network Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,715.35 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,548.13 | Facility | None | $1,479.11 | $1,905.46 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $3,630.78 Typical High $6,918.31 | Professional | None | $1,778.28 | $3,630.78 | $6,918.31 |
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 $2,344.23 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,344.23 | $3,090.30 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Security Health Setting Professional Modifier None Typical Low $5,248.07 Median $7,079.46 Typical High $9,120.11 | Professional | None | $5,248.07 | $7,079.46 | $9,120.11 |
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 $1,698.24 Median $2,818.38 Typical High $7,585.78 | Professional | None | $1,698.24 | $2,818.38 | $7,585.78 |
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 $891.25 Median $891.25 Typical High $10,000.00 | Professional | 52 · Reduced service | $891.25 | $891.25 | $10,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $3,981.07 | Professional | 53 · Discontinued | $363.08 | $363.08 | $3,981.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $14,791.08 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $2,951.21 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $2,951.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $1,995.26 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $1,995.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $13,803.84 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $13,803.84 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,412.54 Median $1,659.59 Typical High $2,818.38 | Professional | 51 · Multiple procedures | $1,412.54 | $1,659.59 | $2,818.38 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,691.53 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,238.72 | $2,691.53 | $4,466.84 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $660.69 Typical High $1,122.02 | Professional | 55 · Aftercare only | $562.34 | $660.69 | $1,122.02 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,818.38 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,818.38 | $4,786.30 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $457.09 | $537.03 | $912.01 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $537.03 | $912.01 |
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
$3,548
AK $5,888TX $1,096
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.