How much rates vary
Facilitymedian $5,888 · 10th to 90th $891 to $16,218Professionalmedian $8,318 · 10th to 90th $4,467 to $30,903
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 $44,668.36 | Professional | None | $4,466.84 | $4,466.84 | $44,668.36 |
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 $4,168.69 Median $13,182.57 Typical High $31,622.78 | Professional | None | $4,168.69 | $13,182.57 | $31,622.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,630.27 Median $8,511.38 Typical High $19,952.62 | Professional | 62 · Two surgeons | $2,630.27 | $8,511.38 | $19,952.62 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $2,137.96 Typical High $5,128.61 | Professional | 80 · Assistant surgeon | $660.69 | $2,137.96 | $5,128.61 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $1,862.09 Typical High $4,466.84 | Professional | AS · PA/NP assist | $575.44 | $1,862.09 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $10,471.29 Typical High $16,218.10 | Facility | None | $812.83 | $10,471.29 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $16,982.44 | Professional | None | $5,248.07 | $7,585.78 | $16,982.44 |
DeanCare Setting Facility Modifier None Typical Low $4,466.84 Median $7,943.28 Typical High $14,791.08 | Facility | None | $4,466.84 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $7,079.46 Median $8,317.64 Typical High $14,125.38 | Professional | None | $7,079.46 | $8,317.64 | $14,125.38 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $4,466.84 Median $5,248.07 Typical High $8,912.51 | Professional | 62 · Two surgeons | $4,466.84 | $5,248.07 | $8,912.51 |
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 $1,000.00 Median $1,174.90 Typical High $1,949.84 | Professional | AS · PA/NP assist | $1,000.00 | $1,174.90 | $1,949.84 |
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 $4,786.30 Median $15,488.17 Typical High $30,902.95 | Professional | None | $4,786.30 | $15,488.17 | $30,902.95 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $6,025.60 Typical High $7,943.28 | Facility | None | $2,089.30 | $6,025.60 | $7,943.28 |
Network Health Setting Professional Modifier None Typical Low $5,623.41 Median $8,912.51 Typical High $11,748.98 | Professional | None | $5,623.41 | $8,912.51 | $11,748.98 |
Prevea360 Setting Facility Modifier None Typical Low $3,715.35 Median $4,466.84 Typical High $8,912.51 | Facility | None | $3,715.35 | $4,466.84 | $8,912.51 |
Quartz Setting Professional Modifier None Typical Low $4,466.84 Median $9,120.11 Typical High $17,378.01 | Professional | None | $4,466.84 | $9,120.11 | $17,378.01 |
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 $5,495.41 Median $7,585.78 Typical High $9,332.54 | Professional | None | $5,495.41 | $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 $13,182.57 Median $17,782.79 Typical High $22,387.21 | Professional | None | $13,182.57 | $17,782.79 | $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 $4,168.69 Median $6,918.31 Typical High $18,620.87 | Professional | None | $4,168.69 | $6,918.31 | $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 $21,877.62 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $21,877.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $8,912.51 | Professional | 53 · Discontinued | $891.25 | $891.25 | $8,912.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,388.44 Typical High $33,113.11 | Professional | 54 · Surgery only | $3,388.44 | $3,388.44 | $33,113.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $676.08 Typical High $6,606.93 | Professional | 55 · Aftercare only | $676.08 | $676.08 | $6,606.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $4,466.84 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $4,466.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,162.28 Typical High $30,902.95 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,162.28 | $30,902.95 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $3,548.13 Median $4,168.69 Typical High $7,079.46 | Professional | 51 · Multiple procedures | $3,548.13 | $4,168.69 | $7,079.46 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $5,623.41 Median $6,606.93 Typical High $11,220.18 | Professional | 54 · Surgery only | $5,623.41 | $6,606.93 | $11,220.18 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $1,412.54 Median $1,659.59 Typical High $2,818.38 | Professional | 55 · Aftercare only | $1,412.54 | $1,659.59 | $2,818.38 |
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 20.9 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· 8th of 51
$7,943
AK $14,125TX $676
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.