How much rates vary
Facilitymedian $5,248 · 10th to 90th $813 to $16,218Professionalmedian $3,090 · 10th to 90th $1,698 to $12,023
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 $1,698.24 Median $1,698.24 Typical High $14,454.40 | Facility | None | $1,698.24 | $1,698.24 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $14,454.40 | Professional | None | $1,698.24 | $1,698.24 | $14,454.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,128.31 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,128.31 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $12,022.64 | Professional | None | $1,513.56 | $4,897.79 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $3,162.28 Typical High $7,585.78 | Professional | 62 · Two surgeons | $954.99 | $3,162.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $794.33 Typical High $1,905.46 | Professional | 80 · Assistant surgeon | $245.47 | $794.33 | $1,905.46 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $691.83 Typical High $1,659.59 | Professional | AS · PA/NP assist | $213.80 | $691.83 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,981.07 Typical High $6,025.60 | Facility | None | $812.83 | $3,981.07 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $6,456.54 | Professional | None | $1,949.84 | $2,884.03 | $6,456.54 |
DeanCare Setting Facility Modifier None Typical Low $1,698.24 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,698.24 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $5,248.07 | Professional | None | $2,630.27 | $3,162.28 | $5,248.07 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $1,949.84 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,659.59 | $1,949.84 | $3,311.31 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $501.19 Typical High $831.76 | Professional | 80 · Assistant surgeon | $426.58 | $501.19 | $831.76 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $436.52 Typical High $741.31 | Professional | AS · PA/NP assist | $371.54 | $436.52 | $741.31 |
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 $1,819.70 Median $5,754.40 Typical High $12,022.64 | Professional | None | $1,819.70 | $5,754.40 | $12,022.64 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $3,090.30 | Facility | None | $2,089.30 | $2,238.72 | $3,090.30 |
Network Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,089.30 | $3,467.37 | $4,466.84 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,778.28 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $1,659.59 Median $3,388.44 Typical High $6,606.93 | Professional | None | $1,659.59 | $3,388.44 | $6,606.93 |
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 $2,187.76 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,884.03 | $3,548.13 |
Security Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $6,606.93 Typical High $8,511.38 | Professional | None | $4,897.79 | $6,606.93 | $8,511.38 |
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 $1,584.89 Median $2,630.27 Typical High $7,079.46 | Professional | None | $1,584.89 | $2,630.27 | $7,079.46 |
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 $851.14 Median $851.14 Typical High $7,244.36 | Professional | 52 · Reduced service | $851.14 | $851.14 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $2,884.03 | Professional | 53 · Discontinued | $338.84 | $338.84 | $2,884.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $10,964.78 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $2,187.76 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $1,445.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $10,232.93 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $10,232.93 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,318.26 Median $1,548.82 Typical High $2,630.27 | Professional | 51 · Multiple procedures | $1,318.26 | $1,548.82 | $2,630.27 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,511.89 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,137.96 | $2,511.89 | $4,168.69 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $630.96 Typical High $1,047.13 | Professional | 55 · Aftercare only | $537.03 | $630.96 | $1,047.13 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,630.27 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,630.27 | $4,365.16 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $426.58 Median $501.19 Typical High $831.76 | Professional | 81 · Minimal assistant surgeon | $426.58 | $501.19 | $831.76 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $426.58 Median $501.19 Typical High $831.76 | Professional | 82 · Assistant surgeon, no resident | $426.58 | $501.19 | $831.76 |
Where Wisconsin sits
The same service costs 20.9 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
$3,311
AK $5,370TX $257
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.