How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $10,471Professionalmedian $2,188 · 10th to 90th $1,175 to $8,128
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 $1,230.27 Median $3,090.30 Typical High $14,454.40 | Facility | None | $1,230.27 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $10,232.93 | Professional | None | $1,122.02 | $1,230.27 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $8,709.64 | Facility | None | $2,818.38 | $4,786.30 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $3,548.13 Typical High $8,511.38 | Professional | None | $1,071.52 | $3,548.13 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $2,238.72 Typical High $5,370.32 | Professional | 62 · Two surgeons | $676.08 | $2,238.72 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $562.34 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $173.78 | $562.34 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $501.19 Typical High $1,202.26 | Professional | AS · PA/NP assist | $151.36 | $501.19 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,884.03 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $4,570.88 | Professional | None | $1,380.38 | $2,089.30 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $5,888.44 | Facility | None | $1,202.26 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,630.78 | Professional | None | $1,905.46 | $2,238.72 | $3,630.78 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $2,290.87 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $363.08 Typical High $575.44 | Professional | 80 · Assistant surgeon | $309.03 | $363.08 | $575.44 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $501.19 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $501.19 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,148.15 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $8,128.31 | Professional | None | $1,230.27 | $4,073.80 | $8,128.31 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,398.83 | $3,162.28 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $1,202.26 Typical High $2,187.76 | Facility | None | $575.44 | $1,202.26 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $2,398.83 Typical High $4,677.35 | Professional | None | $1,174.90 | $2,398.83 | $4,677.35 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $3,981.07 | Facility | None | $724.44 | $2,398.83 | $3,981.07 |
Quartz Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,479.11 | $2,089.30 | $2,511.89 |
Security Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,677.35 Typical High $6,025.60 | Professional | None | $3,548.13 | $4,677.35 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,819.70 Typical High $5,011.87 | Professional | None | $1,071.52 | $1,819.70 | $5,011.87 |
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 $562.34 Median $602.56 Typical High $5,128.61 | Professional | 52 · Reduced service | $562.34 | $602.56 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $2,041.74 | Professional | 53 · Discontinued | $223.87 | $245.47 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $7,585.78 | Professional | 54 · Surgery only | $851.14 | $912.01 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $1,513.56 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $7,079.46 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,122.02 Typical High $1,819.70 | Professional | 51 · Multiple procedures | $954.99 | $1,122.02 | $1,819.70 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $2,884.03 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $446.68 Typical High $724.44 | Professional | 55 · Aftercare only | $380.19 | $446.68 | $724.44 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,905.46 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,905.46 | $3,019.95 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $363.08 Typical High $575.44 | Professional | 81 · Minimal assistant surgeon | $309.03 | $363.08 | $575.44 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $363.08 Typical High $575.44 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $363.08 | $575.44 |
Where Wisconsin sits
The same service costs 5.2 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
$2,455
AK $3,981TX $759
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.