How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,479 to $20,417Professionalmedian $2,455 · 10th to 90th $1,318 to $9,120
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 $1,318.26 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,318.26 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $11,220.18 | Professional | None | $1,318.26 | $1,318.26 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $15,848.93 Typical High $23,988.33 | Facility | None | $11,220.18 | $15,848.93 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $3,981.07 Typical High $9,332.54 | Professional | None | $1,202.26 | $3,981.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $2,454.71 Typical High $5,888.44 | Professional | 62 · Two surgeons | $758.58 | $2,454.71 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $630.96 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $194.98 | $630.96 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $549.54 Typical High $1,318.26 | Professional | AS · PA/NP assist | $169.82 | $549.54 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,168.69 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,168.69 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $5,011.87 | Professional | None | $1,548.82 | $2,238.72 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $8,128.31 Typical High $15,135.61 | Facility | None | $1,318.26 | $8,128.31 | $15,135.61 |
DeanCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $4,168.69 | Professional | None | $2,089.30 | $2,454.71 | $4,168.69 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,548.82 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,318.26 | $1,548.82 | $2,630.27 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $660.69 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $660.69 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $575.44 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $575.44 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $9,332.54 Typical High $19,952.62 | Facility | None | $1,412.54 | $9,332.54 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $4,570.88 Typical High $9,120.11 | Professional | None | $1,412.54 | $4,570.88 | $9,120.11 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,754.23 | $3,548.13 |
Prevea360 Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,511.89 | Facility | None | $1,096.48 | $1,318.26 | $2,511.89 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $2,691.53 Typical High $5,128.61 | Professional | None | $1,318.26 | $2,691.53 | $5,128.61 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $8,511.38 Typical High $14,125.38 | Facility | None | $812.83 | $8,511.38 | $14,125.38 |
Quartz Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,238.72 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $5,128.61 Typical High $6,606.93 | Professional | None | $3,890.45 | $5,128.61 | $6,606.93 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,258.93 | $2,041.74 | $5,495.41 |
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 $660.69 Median $660.69 Typical High $5,623.41 | Professional | 52 · Reduced service | $660.69 | $660.69 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $2,238.72 | Professional | 53 · Discontinued | $263.03 | $263.03 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $8,511.38 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $1,698.24 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $7,943.28 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,047.13 Median $1,230.27 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,047.13 | $1,230.27 | $2,089.30 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,949.84 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,659.59 | $1,949.84 | $3,311.31 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $489.78 Typical High $831.76 | Professional | 55 · Aftercare only | $416.87 | $489.78 | $831.76 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,089.30 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,089.30 | $3,467.37 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $338.84 Median $398.11 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $338.84 | $398.11 | $660.69 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $338.84 Median $398.11 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $338.84 | $398.11 | $660.69 |
Where Wisconsin sits
The same service costs 25.7 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· 3rd of 51
$2,818
AK $5,129TX $200
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.