How much rates vary
Facilitymedian $6,026 · 10th to 90th $813 to $16,218Professionalmedian $8,128 · 10th to 90th $4,467 to $31,623
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 $4,466.84 Median $4,466.84 Typical High $14,454.40 | Facility | None | $4,466.84 | $4,466.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $33,884.42 | Professional | None | $4,466.84 | $4,466.84 | $33,884.42 |
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 $4,073.80 Median $13,182.57 Typical High $30,902.95 | Professional | None | $4,073.80 | $13,182.57 | $30,902.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $8,317.64 Typical High $19,498.45 | Professional | 62 · Two surgeons | $2,570.40 | $8,317.64 | $19,498.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $2,089.30 Typical High $4,897.79 | Professional | 80 · Assistant surgeon | $660.69 | $2,089.30 | $4,897.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $1,819.70 Typical High $4,265.80 | Professional | AS · PA/NP assist | $575.44 | $1,819.70 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $10,471.29 Typical High $15,848.93 | Facility | None | $812.83 | $10,471.29 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $5,128.61 Median $7,585.78 Typical High $16,595.87 | Professional | None | $5,128.61 | $7,585.78 | $16,595.87 |
DeanCare Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $14,454.40 | Facility | None | $4,365.16 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $6,918.31 Median $8,128.31 Typical High $13,803.84 | Professional | None | $6,918.31 | $8,128.31 | $13,803.84 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $4,365.16 Median $5,128.61 Typical High $8,709.64 | Professional | 62 · Two surgeons | $4,365.16 | $5,128.61 | $8,709.64 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $1,122.02 Median $1,318.26 Typical High $2,238.72 | Professional | 80 · Assistant surgeon | $1,122.02 | $1,318.26 | $2,238.72 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $977.24 Median $1,148.15 Typical High $1,949.84 | Professional | AS · PA/NP assist | $977.24 | $1,148.15 | $1,949.84 |
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 $4,677.35 Median $15,135.61 Typical High $31,622.78 | Professional | None | $4,677.35 | $15,135.61 | $31,622.78 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $5,888.44 Typical High $7,762.47 | Facility | None | $2,089.30 | $5,888.44 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $5,495.41 Median $8,709.64 Typical High $11,220.18 | Professional | None | $5,495.41 | $8,709.64 | $11,220.18 |
Prevea360 Setting Facility Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $8,709.64 | Facility | None | $3,630.78 | $4,466.84 | $8,709.64 |
Quartz Setting Professional Modifier None Typical Low $4,365.16 Median $8,912.51 Typical High $16,982.44 | Professional | None | $4,365.16 | $8,912.51 | $16,982.44 |
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 $5,370.32 Median $7,585.78 Typical High $9,332.54 | Professional | None | $5,370.32 | $7,585.78 | $9,332.54 |
Security Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Professional | None | $14,791.08 | $14,791.08 | $14,791.08 |
Security Health Setting Professional Modifier None Typical Low $12,589.25 Median $16,982.44 Typical High $22,387.21 | Professional | None | $12,589.25 | $16,982.44 | $22,387.21 |
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 $3,981.07 Median $6,760.83 Typical High $18,620.87 | Professional | None | $3,981.07 | $6,760.83 | $18,620.87 |
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 $2,238.72 Median $2,238.72 Typical High $16,982.44 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $16,982.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $6,760.83 | Professional | 53 · Discontinued | $891.25 | $891.25 | $6,760.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $25,703.96 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $25,703.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $5,128.61 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $5,128.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $3,388.44 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $3,388.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $23,988.33 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $23,988.33 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $3,467.37 Median $4,073.80 Typical High $6,918.31 | Professional | 51 · Multiple procedures | $3,467.37 | $4,073.80 | $6,918.31 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $5,623.41 Median $6,606.93 Typical High $10,964.78 | Professional | 54 · Surgery only | $5,623.41 | $6,606.93 | $10,964.78 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,380.38 Median $1,659.59 Typical High $2,754.23 | Professional | 55 · Aftercare only | $1,380.38 | $1,659.59 | $2,754.23 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,888.44 Median $6,918.31 Typical High $11,748.98 | Professional | 78 · Unplanned return to OR | $5,888.44 | $6,918.31 | $11,748.98 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $1,122.02 Median $1,318.26 Typical High $2,238.72 | Professional | 81 · Minimal assistant surgeon | $1,122.02 | $1,318.26 | $2,238.72 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $1,122.02 Median $1,318.26 Typical High $2,238.72 | Professional | 82 · Assistant surgeon, no resident | $1,122.02 | $1,318.26 | $2,238.72 |
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
$7,943
AK $14,125TX $646
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.