How much rates vary
Facilitymedian $5,129 · 10th to 90th $724 to $16,218Professionalmedian $1,318 · 10th to 90th $724 to $4,898
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 $724.44 Median $724.44 Typical High $14,454.40 | Facility | None | $724.44 | $724.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $5,754.40 | Professional | None | $707.95 | $724.44 | $5,754.40 |
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 $645.65 Median $1,995.26 Typical High $4,677.35 | Professional | None | $645.65 | $1,995.26 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $1,258.93 Typical High $2,951.21 | Professional | 62 · Two surgeons | $416.87 | $1,258.93 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $323.59 Typical High $741.31 | Professional | 80 · Assistant surgeon | $102.33 | $323.59 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $281.84 Typical High $660.69 | Professional | AS · PA/NP assist | $89.13 | $281.84 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $2,884.03 | Facility | None | $812.83 | $1,698.24 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $2,754.23 | Professional | None | $812.83 | $1,230.27 | $2,754.23 |
DeanCare Setting Facility Modifier None Typical Low $724.44 Median $7,943.28 Typical High $14,454.40 | Facility | None | $724.44 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,348.96 | $2,137.96 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $1,348.96 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $1,348.96 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $346.74 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $346.74 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $302.00 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $302.00 |
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 $741.31 Median $2,398.83 Typical High $4,897.79 | Professional | None | $741.31 | $2,398.83 | $4,897.79 |
Network Health Setting Facility Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,089.30 | Facility | None | $954.99 | $1,202.26 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,737.80 | Professional | None | $891.25 | $1,348.96 | $1,737.80 |
Prevea360 Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $1,348.96 | Facility | None | $602.56 | $758.58 | $1,348.96 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $1,513.56 Typical High $2,754.23 | Professional | None | $741.31 | $1,513.56 | $2,754.23 |
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 $870.96 Median $1,230.27 Typical High $1,479.11 | Professional | None | $870.96 | $1,230.27 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,511.89 | $3,548.13 |
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 $660.69 Median $1,047.13 Typical High $2,951.21 | Professional | None | $660.69 | $1,047.13 | $2,951.21 |
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 $354.81 Median $363.08 Typical High $2,818.38 | Professional | 52 · Reduced service | $354.81 | $363.08 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $1,148.15 | Professional | 53 · Discontinued | $144.54 | $144.54 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Professional | 54 · Surgery only | $537.03 | $537.03 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $851.14 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $3,981.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $676.08 Typical High $1,071.52 | Professional | 51 · Multiple procedures | $575.44 | $676.08 | $1,071.52 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,698.24 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,698.24 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $426.58 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $426.58 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,122.02 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $954.99 | $1,122.02 | $1,819.70 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $181.97 Median $213.80 Typical High $346.74 | Professional | 81 · Minimal assistant surgeon | $181.97 | $213.80 | $346.74 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $181.97 Median $213.80 Typical High $346.74 | Professional | 82 · Assistant surgeon, no resident | $181.97 | $213.80 | $346.74 |
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· 6th of 51
$1,413
AK $2,512TX $468
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.