How much rates vary
Facilitymedian $6,026 · 10th to 90th $813 to $16,218Professionalmedian $7,586 · 10th to 90th $4,074 to $28,840
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 $4,073.80 Median $4,073.80 Typical High $14,454.40 | Facility | None | $4,073.80 | $4,073.80 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $31,622.78 | Professional | None | $4,073.80 | $4,073.80 | $31,622.78 |
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 $3,715.35 Median $12,022.64 Typical High $27,542.29 | Professional | None | $3,715.35 | $12,022.64 | $27,542.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $7,585.78 Typical High $17,378.01 | Professional | 62 · Two surgeons | $2,398.83 | $7,585.78 | $17,378.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $1,905.46 Typical High $4,466.84 | Professional | 80 · Assistant surgeon | $602.56 | $1,905.46 | $4,466.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $1,698.24 Typical High $3,890.45 | Professional | AS · PA/NP assist | $524.81 | $1,698.24 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $9,549.93 Typical High $14,791.08 | Facility | None | $812.83 | $9,549.93 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $6,918.31 Typical High $15,488.17 | Professional | None | $4,786.30 | $6,918.31 | $15,488.17 |
DeanCare Setting Facility Modifier None Typical Low $4,073.80 Median $7,943.28 Typical High $14,454.40 | Facility | None | $4,073.80 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $6,456.54 Median $7,585.78 Typical High $12,882.50 | Professional | None | $6,456.54 | $7,585.78 | $12,882.50 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $4,073.80 Median $4,786.30 Typical High $8,128.31 | Professional | 62 · Two surgeons | $4,073.80 | $4,786.30 | $8,128.31 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,023.29 Median $1,202.26 Typical High $2,041.74 | Professional | 80 · Assistant surgeon | $1,023.29 | $1,202.26 | $2,041.74 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $912.01 Median $1,071.52 Typical High $1,778.28 | Professional | AS · PA/NP assist | $912.01 | $1,071.52 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,951.21 Typical High $18,197.01 | Facility | None | $436.52 | $2,951.21 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $4,365.16 Median $14,125.38 Typical High $28,840.32 | Professional | None | $4,365.16 | $14,125.38 | $28,840.32 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $5,495.41 Typical High $7,079.46 | Facility | None | $2,089.30 | $5,495.41 | $7,079.46 |
Network Health Setting Professional Modifier None Typical Low $5,128.61 Median $7,943.28 Typical High $10,232.93 | Professional | None | $5,128.61 | $7,943.28 | $10,232.93 |
Prevea360 Setting Facility Modifier None Typical Low $3,388.44 Median $4,073.80 Typical High $8,128.31 | Facility | None | $3,388.44 | $4,073.80 | $8,128.31 |
Quartz Setting Professional Modifier None Typical Low $3,981.07 Median $8,317.64 Typical High $15,848.93 | Professional | None | $3,981.07 | $8,317.64 | $15,848.93 |
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 $5,011.87 Median $6,918.31 Typical High $8,511.38 | Professional | None | $5,011.87 | $6,918.31 | $8,511.38 |
Security Health Setting Professional Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | None | $13,489.63 | $13,489.63 | $13,489.63 |
Security Health Setting Professional Modifier None Typical Low $11,481.54 Median $15,135.61 Typical High $20,417.38 | Professional | None | $11,481.54 | $15,135.61 | $20,417.38 |
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 $3,801.89 Median $6,309.57 Typical High $16,982.44 | Professional | None | $3,801.89 | $6,309.57 | $16,982.44 |
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 $2,041.74 Median $2,041.74 Typical High $15,848.93 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $15,848.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $6,309.57 | Professional | 53 · Discontinued | $812.83 | $812.83 | $6,309.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,090.30 Typical High $23,442.29 | Professional | 54 · Surgery only | $3,090.30 | $3,090.30 | $23,442.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $616.60 Typical High $4,677.35 | Professional | 55 · Aftercare only | $616.60 | $616.60 | $4,677.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $3,162.28 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $3,162.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $2,884.03 Typical High $21,877.62 | Professional | 78 · Unplanned return to OR | $2,884.03 | $2,884.03 | $21,877.62 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $3,235.94 Median $3,801.89 Typical High $6,456.54 | Professional | 51 · Multiple procedures | $3,235.94 | $3,801.89 | $6,456.54 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $5,128.61 Median $6,025.60 Typical High $10,232.93 | Professional | 54 · Surgery only | $5,128.61 | $6,025.60 | $10,232.93 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,288.25 Median $1,513.56 Typical High $2,570.40 | Professional | 55 · Aftercare only | $1,288.25 | $1,513.56 | $2,570.40 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,370.32 Median $6,309.57 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $5,370.32 | $6,309.57 | $10,715.19 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,023.29 Median $1,202.26 Typical High $2,041.74 | Professional | 81 · Minimal assistant surgeon | $1,023.29 | $1,202.26 | $2,041.74 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,023.29 Median $1,202.26 Typical High $2,041.74 | Professional | 82 · Assistant surgeon, no resident | $1,023.29 | $1,202.26 | $2,041.74 |
Where Wisconsin sits
The same service costs 21.9 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
$7,413
AK $13,183TX $603
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.