How much rates vary
Facilitymedian $5,888 · 10th to 90th $977 to $16,218Professionalmedian $7,762 · 10th to 90th $3,802 to $25,704
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 $3,801.89 Median $3,801.89 Typical High $14,454.40 | Facility | None | $3,801.89 | $3,801.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $37,153.52 | Professional | None | $3,801.89 | $3,801.89 | $37,153.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $10,964.78 Typical High $25,703.96 | Professional | None | $3,630.78 | $10,964.78 | $25,703.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $7,079.46 Typical High $16,218.10 | Professional | 62 · Two surgeons | $2,398.83 | $7,079.46 | $16,218.10 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $1,778.28 Typical High $4,168.69 | Professional | 80 · Assistant surgeon | $602.56 | $1,778.28 | $4,168.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $1,548.82 Typical High $3,630.78 | Professional | AS · PA/NP assist | $524.81 | $1,548.82 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $15,135.61 | Facility | None | $8,912.51 | $10,000.00 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $12,589.25 Typical High $14,125.38 | Professional | None | $5,495.41 | $12,589.25 | $14,125.38 |
DeanCare Setting Facility Modifier None Typical Low $3,715.35 Median $7,943.28 Typical High $14,791.08 | Facility | None | $3,715.35 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $5,888.44 Median $6,918.31 Typical High $11,748.98 | Professional | None | $5,888.44 | $6,918.31 | $11,748.98 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $3,715.35 Median $4,365.16 Typical High $7,413.10 | Professional | 62 · Two surgeons | $3,715.35 | $4,365.16 | $7,413.10 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $954.99 Median $1,122.02 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $954.99 | $1,122.02 | $1,862.09 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $831.76 Median $977.24 Typical High $1,659.59 | Professional | AS · PA/NP assist | $831.76 | $977.24 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $18,197.01 | Facility | None | $436.52 | $2,818.38 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $3,981.07 Median $12,882.50 Typical High $25,703.96 | Professional | None | $3,981.07 | $12,882.50 | $25,703.96 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $5,011.87 Typical High $6,918.31 | Facility | None | $2,089.30 | $5,011.87 | $6,918.31 |
Network Health Setting Professional Modifier None Typical Low $4,677.35 Median $7,585.78 Typical High $9,772.37 | Professional | None | $4,677.35 | $7,585.78 | $9,772.37 |
Prevea360 Setting Facility Modifier None Typical Low $3,090.30 Median $3,715.35 Typical High $7,413.10 | Facility | None | $3,090.30 | $3,715.35 | $7,413.10 |
Quartz Setting Professional Modifier None Typical Low $3,715.35 Median $7,585.78 Typical High $14,454.40 | Professional | None | $3,715.35 | $7,585.78 | $14,454.40 |
Quartz Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Security Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Professional | None | $12,589.25 | $12,589.25 | $12,589.25 |
Security Health Setting Professional Modifier None Typical Low $10,715.19 Median $14,125.38 Typical High $18,620.87 | Professional | None | $10,715.19 | $14,125.38 | $18,620.87 |
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 $3,548.13 Median $5,888.44 Typical High $15,848.93 | Professional | None | $3,548.13 | $5,888.44 | $15,848.93 |
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 $1,862.09 Median $1,862.09 Typical High $18,620.87 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $18,620.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $7,413.10 | Professional | 53 · Discontinued | $758.58 | $758.58 | $7,413.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $27,542.29 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $27,542.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $5,623.41 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $5,623.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $3,715.35 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $3,715.35 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,630.27 Typical High $25,703.96 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,630.27 | $25,703.96 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $2,951.21 Median $3,467.37 Typical High $5,888.44 | Professional | 51 · Multiple procedures | $2,951.21 | $3,467.37 | $5,888.44 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $4,786.30 Median $5,623.41 Typical High $9,332.54 | Professional | 54 · Surgery only | $4,786.30 | $5,623.41 | $9,332.54 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,174.90 Median $1,380.38 Typical High $2,344.23 | Professional | 55 · Aftercare only | $1,174.90 | $1,380.38 | $2,344.23 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,011.87 Median $5,888.44 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $5,011.87 | $5,888.44 | $9,772.37 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $954.99 Median $1,122.02 Typical High $1,862.09 | Professional | 81 · Minimal assistant surgeon | $954.99 | $1,122.02 | $1,862.09 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $954.99 Median $1,122.02 Typical High $1,862.09 | Professional | 82 · Assistant surgeon, no resident | $954.99 | $1,122.02 | $1,862.09 |
Where Wisconsin sits
The same service costs 27.5 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
$7,586
AK $14,454TX $525
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.