How much rates vary
Facilitymedian $5,129 · 10th to 90th $776 to $16,218Professionalmedian $1,698 · 10th to 90th $933 to $6,310
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 $933.25 Median $933.25 Typical High $14,454.40 | Facility | None | $933.25 | $933.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $7,244.36 | Professional | None | $891.25 | $933.25 | $7,244.36 |
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 $851.14 Median $2,754.23 Typical High $6,606.93 | Professional | None | $851.14 | $2,754.23 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $1,737.80 Typical High $4,168.69 | Professional | 62 · Two surgeons | $549.54 | $1,737.80 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $436.52 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $134.90 | $436.52 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $380.19 Typical High $912.01 | Professional | AS · PA/NP assist | $120.23 | $380.19 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $3,630.78 | Facility | None | $812.83 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $3,548.13 | Professional | None | $1,071.52 | $1,584.89 | $3,548.13 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $7,943.28 Typical High $14,454.40 | Facility | None | $933.25 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,737.80 | $2,884.03 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,096.48 Typical High $1,819.70 | Professional | 62 · Two surgeons | $912.01 | $1,096.48 | $1,819.70 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $457.09 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $457.09 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $407.38 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $407.38 |
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 $977.24 Median $3,162.28 Typical High $6,309.57 | Professional | None | $977.24 | $3,162.28 | $6,309.57 |
Network Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,089.30 | Facility | None | $1,230.27 | $1,698.24 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,905.46 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $776.25 Median $977.24 Typical High $1,819.70 | Facility | None | $776.25 | $977.24 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $3,630.78 | Professional | None | $912.01 | $1,905.46 | $3,630.78 |
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 $1,202.26 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,584.89 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Security Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,630.78 Typical High $4,677.35 | Professional | None | $1,949.84 | $3,630.78 | $4,677.35 |
The Alliance Setting Professional Modifier None Typical Low $2,884.03 Median $5,011.87 Typical High $5,128.61 | Professional | None | $2,884.03 | $5,011.87 | $5,128.61 |
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 $851.14 Median $1,445.44 Typical High $3,890.45 | Professional | None | $851.14 | $1,445.44 | $3,890.45 |
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 $467.74 Median $467.74 Typical High $3,630.78 | Professional | 52 · Reduced service | $467.74 | $467.74 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $1,445.44 | Professional | 53 · Discontinued | $186.21 | $186.21 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $5,370.32 | Professional | 54 · Surgery only | $691.83 | $691.83 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $1,071.52 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $724.44 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $5,011.87 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $724.44 Median $851.14 Typical High $1,445.44 | Professional | 51 · Multiple procedures | $724.44 | $851.14 | $1,445.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,380.38 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,174.90 | $1,380.38 | $2,290.87 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $346.74 Typical High $575.44 | Professional | 55 · Aftercare only | $295.12 | $346.74 | $575.44 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,445.44 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,445.44 | $2,398.83 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $234.42 Median $275.42 Typical High $457.09 | Professional | 81 · Minimal assistant surgeon | $234.42 | $275.42 | $457.09 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $234.42 Median $275.42 Typical High $457.09 | Professional | 82 · Assistant surgeon, no resident | $234.42 | $275.42 | $457.09 |
Where Wisconsin sits
The same service costs 11.5 times more in Maine than in Maryland. 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.
Physician feeFacility fee
ME $16,997MD $1,474
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.