How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $1,995 · 10th to 90th $1,072 to $7,244
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 $1,071.52 Median $1,071.52 Typical High $14,454.40 | Facility | None | $1,071.52 | $1,071.52 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $9,120.11 | Professional | None | $1,071.52 | $1,071.52 | $9,120.11 |
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 $977.24 Median $3,235.94 Typical High $7,585.78 | Professional | None | $977.24 | $3,235.94 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $2,041.74 Typical High $4,786.30 | Professional | 62 · Two surgeons | $630.96 | $2,041.74 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $512.86 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $158.49 | $512.86 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $446.68 Typical High $1,047.13 | Professional | AS · PA/NP assist | $138.04 | $446.68 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,570.40 Typical High $3,890.45 | Facility | None | $812.83 | $2,570.40 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $4,073.80 | Professional | None | $1,230.27 | $1,819.70 | $4,073.80 |
DeanCare Setting Facility Modifier None Typical Low $1,071.52 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,071.52 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,698.24 | $1,995.26 | $3,311.31 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,258.93 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,071.52 | $1,258.93 | $2,089.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $316.23 Typical High $524.81 | Professional | 80 · Assistant surgeon | $269.15 | $316.23 | $524.81 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $457.09 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $457.09 |
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 $1,122.02 Median $3,630.78 Typical High $7,244.36 | Professional | None | $1,122.02 | $3,630.78 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $2,089.30 | Facility | None | $1,445.44 | $1,995.26 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,348.96 | $2,187.76 | $2,818.38 |
Prevea360 Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,041.74 | Facility | None | $891.25 | $1,148.15 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $1,096.48 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,096.48 | $2,238.72 | $4,168.69 |
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 $1,380.38 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,819.70 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $3,090.30 Median $4,168.69 Typical High $5,495.41 | Professional | None | $3,090.30 | $4,168.69 | $5,495.41 |
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 $1,000.00 Median $1,659.59 Typical High $4,466.84 | Professional | None | $1,000.00 | $1,659.59 | $4,466.84 |
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 $537.03 Median $537.03 Typical High $4,570.88 | Professional | 52 · Reduced service | $537.03 | $537.03 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $1,862.09 | Professional | 53 · Discontinued | $213.80 | $213.80 | $1,862.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $6,918.31 | Professional | 54 · Surgery only | $794.33 | $812.83 | $6,918.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $1,380.38 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $912.01 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $6,456.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $851.14 Median $1,000.00 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $851.14 | $1,000.00 | $1,659.59 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,584.89 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,348.96 | $1,584.89 | $2,630.27 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $398.11 Typical High $660.69 | Professional | 55 · Aftercare only | $338.84 | $398.11 | $660.69 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $2,754.23 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $269.15 Median $316.23 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $269.15 | $316.23 | $524.81 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $269.15 Median $316.23 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $269.15 | $316.23 | $524.81 |
Where Wisconsin sits
The same service costs 4.9 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
$2,188
AK $3,548TX $724
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.