How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $2,570 · 10th to 90th $1,413 to $10,965
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 $1,412.54 Median $1,412.54 Typical High $14,454.40 | Facility | None | $1,412.54 | $1,412.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $12,589.25 | Professional | None | $1,318.26 | $1,412.54 | $12,589.25 |
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 $1,318.26 Median $4,168.69 Typical High $10,000.00 | Professional | None | $1,318.26 | $4,168.69 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $2,630.27 Typical High $6,456.54 | Professional | 62 · Two surgeons | $831.76 | $2,630.27 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $660.69 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $208.93 | $660.69 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $588.84 Typical High $1,445.44 | Professional | AS · PA/NP assist | $181.97 | $588.84 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,311.31 Typical High $5,128.61 | Facility | None | $812.83 | $3,311.31 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $5,370.32 | Professional | None | $1,621.81 | $2,398.83 | $5,370.32 |
DeanCare Setting Facility Modifier None Typical Low $1,412.54 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,412.54 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,238.72 | $2,630.27 | $4,265.80 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,659.59 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,412.54 | $1,659.59 | $2,691.53 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | 80 · Assistant surgeon | $354.81 | $416.87 | $691.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $371.54 Typical High $602.56 | Professional | AS · PA/NP assist | $316.23 | $371.54 | $602.56 |
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 $1,513.56 Median $4,786.30 Typical High $11,481.54 | Professional | None | $1,513.56 | $4,786.30 | $11,481.54 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,691.53 | Facility | None | $1,862.09 | $2,089.30 | $2,691.53 |
Network Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,951.21 | $3,801.89 |
Prevea360 Setting Facility Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,174.90 | $1,513.56 | $2,630.27 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,495.41 | Professional | None | $1,318.26 | $2,754.23 | $5,495.41 |
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 $1,778.28 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,398.83 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $5,623.41 Typical High $7,079.46 | Professional | None | $4,265.80 | $5,623.41 | $7,079.46 |
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 $1,288.25 Median $2,187.76 Typical High $5,888.44 | Professional | None | $1,288.25 | $2,187.76 | $5,888.44 |
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 $660.69 Median $707.95 Typical High $6,309.57 | Professional | 52 · Reduced service | $660.69 | $707.95 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $2,511.89 | Professional | 53 · Discontinued | $263.03 | $281.84 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $9,332.54 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $1,862.09 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $8,709.64 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,318.26 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,122.02 | $1,318.26 | $2,137.96 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,089.30 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,778.28 | $2,089.30 | $3,467.37 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $524.81 Typical High $870.96 | Professional | 55 · Aftercare only | $446.68 | $524.81 | $870.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,187.76 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,187.76 | $3,630.78 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $354.81 | $416.87 | $691.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $416.87 | $691.83 |
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· 4th of 51
$2,818
AK $4,571TX $851
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.