How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $3,020 · 10th to 90th $1,622 to $11,220
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 $1,621.81 Median $1,621.81 Typical High $14,454.40 | Facility | None | $1,621.81 | $1,621.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $12,589.25 | Professional | None | $1,621.81 | $1,621.81 | $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 $1,479.11 Median $4,786.30 Typical High $10,964.78 | Professional | None | $1,479.11 | $4,786.30 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $3,090.30 Typical High $6,918.31 | Professional | 62 · Two surgeons | $933.25 | $3,090.30 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $776.25 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $239.88 | $776.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $676.08 Typical High $1,548.82 | Professional | AS · PA/NP assist | $208.93 | $676.08 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,801.89 Typical High $5,888.44 | Facility | None | $812.83 | $3,801.89 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $6,165.95 | Professional | None | $1,862.09 | $2,754.23 | $6,165.95 |
DeanCare Setting Facility Modifier None Typical Low $1,621.81 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,621.81 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $5,011.87 | Professional | None | $2,570.40 | $3,019.95 | $5,011.87 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,905.46 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,621.81 | $1,905.46 | $3,162.28 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $478.63 Typical High $812.83 | Professional | 80 · Assistant surgeon | $407.38 | $478.63 | $812.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $426.58 Typical High $707.95 | Professional | AS · PA/NP assist | $354.81 | $426.58 | $707.95 |
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 $1,698.24 Median $5,623.41 Typical High $11,220.18 | Professional | None | $1,698.24 | $5,623.41 | $11,220.18 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,951.21 | Facility | None | $2,089.30 | $2,187.76 | $2,951.21 |
Network Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,041.74 | $3,235.94 | $4,168.69 |
Prevea360 Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $3,162.28 | Facility | None | $1,348.96 | $1,621.81 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,311.31 Typical High $6,309.57 | Professional | None | $1,621.81 | $3,311.31 | $6,309.57 |
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 $2,041.74 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,754.23 | $3,388.44 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,165.95 Typical High $8,128.31 | Professional | None | $4,677.35 | $6,165.95 | $8,128.31 |
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 $1,479.11 Median $2,454.71 Typical High $6,760.83 | Professional | None | $1,479.11 | $2,454.71 | $6,760.83 |
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 $812.83 Median $812.83 Typical High $6,309.57 | Professional | 52 · Reduced service | $812.83 | $812.83 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $2,511.89 | Professional | 53 · Discontinued | $323.59 | $323.59 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $9,549.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $1,905.46 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $8,912.51 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,288.25 Median $1,513.56 Typical High $2,511.89 | Professional | 51 · Multiple procedures | $1,288.25 | $1,513.56 | $2,511.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,398.83 Typical High $4,073.80 | Professional | 54 · Surgery only | $2,041.74 | $2,398.83 | $4,073.80 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $602.56 Typical High $1,000.00 | Professional | 55 · Aftercare only | $512.86 | $602.56 | $1,000.00 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,511.89 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,511.89 | $4,265.80 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $407.38 Median $478.63 Typical High $812.83 | Professional | 81 · Minimal assistant surgeon | $407.38 | $478.63 | $812.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $407.38 Median $478.63 Typical High $812.83 | Professional | 82 · Assistant surgeon, no resident | $407.38 | $478.63 | $812.83 |
Where Wisconsin sits
The same service costs 5.1 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
$3,236
AK $5,129TX $1,000
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.