How much rates vary
Facilitymedian $5,623 · 10th to 90th $813 to $16,218Professionalmedian $4,786 · 10th to 90th $2,570 to $17,783
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 $2,570.40 Median $2,570.40 Typical High $14,454.40 | Facility | None | $2,570.40 | $2,570.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $21,379.62 | Professional | None | $2,570.40 | $2,570.40 | $21,379.62 |
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 $2,398.83 Median $7,585.78 Typical High $18,197.01 | Professional | None | $2,398.83 | $7,585.78 | $18,197.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $4,897.79 Typical High $11,481.54 | Professional | 62 · Two surgeons | $1,513.56 | $4,897.79 | $11,481.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $1,230.27 Typical High $2,951.21 | Professional | 80 · Assistant surgeon | $380.19 | $1,230.27 | $2,951.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $1,071.52 Typical High $2,570.40 | Professional | AS · PA/NP assist | $331.13 | $1,071.52 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,025.60 Typical High $9,332.54 | Facility | None | $812.83 | $6,025.60 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $4,365.16 Typical High $9,772.37 | Professional | None | $3,019.95 | $4,365.16 | $9,772.37 |
DeanCare Setting Facility Modifier None Typical Low $2,570.40 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,570.40 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $8,128.31 | Professional | None | $4,073.80 | $4,786.30 | $8,128.31 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $3,019.95 Typical High $5,128.61 | Professional | 62 · Two surgeons | $2,570.40 | $3,019.95 | $5,128.61 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $758.58 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $645.65 | $758.58 | $1,288.25 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $676.08 Typical High $1,148.15 | Professional | AS · PA/NP assist | $575.44 | $676.08 | $1,148.15 |
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 $2,754.23 Median $8,912.51 Typical High $17,782.79 | Professional | None | $2,754.23 | $8,912.51 | $17,782.79 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $4,786.30 | Facility | None | $2,089.30 | $3,467.37 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $6,918.31 | Professional | None | $3,235.94 | $5,370.32 | $6,918.31 |
Prevea360 Setting Facility Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $5,128.61 | Facility | None | $2,137.96 | $2,570.40 | $5,128.61 |
Quartz Setting Professional Modifier None Typical Low $2,511.89 Median $5,248.07 Typical High $10,000.00 | Professional | None | $2,511.89 | $5,248.07 | $10,000.00 |
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 $3,388.44 Median $4,365.16 Typical High $5,370.32 | Professional | None | $3,388.44 | $4,365.16 | $5,370.32 |
Security Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Security Health Setting Professional Modifier None Typical Low $7,585.78 Median $10,232.93 Typical High $12,882.50 | Professional | None | $7,585.78 | $10,232.93 | $12,882.50 |
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 $2,398.83 Median $4,073.80 Typical High $10,964.78 | Professional | None | $2,398.83 | $4,073.80 | $10,964.78 |
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 $1,288.25 Median $1,288.25 Typical High $10,715.19 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $10,715.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $4,365.16 | Professional | 53 · Discontinued | $512.86 | $512.86 | $4,365.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $16,218.10 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $16,218.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $3,235.94 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $3,235.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $2,137.96 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $2,137.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $15,135.61 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $15,135.61 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,041.74 Median $2,398.83 Typical High $4,073.80 | Professional | 51 · Multiple procedures | $2,041.74 | $2,398.83 | $4,073.80 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $3,235.94 Median $3,801.89 Typical High $6,456.54 | Professional | 54 · Surgery only | $3,235.94 | $3,801.89 | $6,456.54 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $954.99 Typical High $1,621.81 | Professional | 55 · Aftercare only | $812.83 | $954.99 | $1,621.81 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $4,073.80 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $3,388.44 | $4,073.80 | $6,760.83 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $645.65 Median $758.58 Typical High $1,288.25 | Professional | 81 · Minimal assistant surgeon | $645.65 | $758.58 | $1,288.25 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $645.65 Median $758.58 Typical High $1,288.25 | Professional | 82 · Assistant surgeon, no resident | $645.65 | $758.58 | $1,288.25 |
Where Wisconsin sits
The same service costs 21.4 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· 6th of 51
$4,898
AK $8,318TX $389
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.