How much rates vary
Facilitymedian $5,370 · 10th to 90th $832 to $16,218Professionalmedian $2,884 · 10th to 90th $1,549 to $10,715
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 $1,548.82 Median $8,511.38 Typical High $14,454.40 | Facility | None | $1,548.82 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $13,182.57 | Professional | None | $1,548.82 | $1,548.82 | $13,182.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,317.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $4,677.35 Typical High $10,715.19 | Professional | None | $1,445.44 | $4,677.35 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $2,951.21 Typical High $6,760.83 | Professional | 62 · Two surgeons | $912.01 | $2,951.21 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $741.31 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $229.09 | $741.31 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $645.65 Typical High $1,513.56 | Professional | AS · PA/NP assist | $199.53 | $645.65 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $5,623.41 | Facility | None | $812.83 | $3,630.78 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $5,888.44 | Professional | None | $1,819.70 | $2,630.27 | $5,888.44 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $7,943.28 Typical High $14,791.08 | Facility | None | $1,548.82 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,884.03 | $4,897.79 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,819.70 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,548.82 | $1,819.70 | $3,090.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $467.74 Typical High $776.25 | Professional | 80 · Assistant surgeon | $389.05 | $467.74 | $776.25 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $407.38 Typical High $676.08 | Professional | AS · PA/NP assist | $346.74 | $407.38 | $676.08 |
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 $1,698.24 Median $5,370.32 Typical High $10,715.19 | Professional | None | $1,698.24 | $5,370.32 | $10,715.19 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Facility | None | $2,089.30 | $2,089.30 | $2,884.03 |
Network Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,235.94 Typical High $4,168.69 | Professional | None | $1,949.84 | $3,235.94 | $4,168.69 |
Prevea360 Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,019.95 | Facility | None | $1,288.25 | $1,548.82 | $3,019.95 |
Quartz Setting Professional Modifier None Typical Low $1,548.82 Median $3,162.28 Typical High $6,025.60 | Professional | None | $1,548.82 | $3,162.28 | $6,025.60 |
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 $2,041.74 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,041.74 | $2,630.27 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $5,888.44 Typical High $7,762.47 | Professional | None | $4,466.84 | $5,888.44 | $7,762.47 |
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 $1,479.11 Median $2,398.83 Typical High $6,456.54 | Professional | None | $1,479.11 | $2,398.83 | $6,456.54 |
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 $776.25 Median $776.25 Typical High $6,606.93 | Professional | 52 · Reduced service | $776.25 | $776.25 | $6,606.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $2,630.27 | Professional | 53 · Discontinued | $309.03 | $309.03 | $2,630.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $10,000.00 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $10,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $1,995.26 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $1,995.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $1,318.26 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $1,318.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $9,332.54 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $9,332.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,445.44 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $1,230.27 | $1,445.44 | $2,454.71 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,290.87 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,949.84 | $2,290.87 | $3,890.45 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $575.44 Typical High $977.24 | Professional | 55 · Aftercare only | $489.78 | $575.44 | $977.24 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,454.71 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,454.71 | $4,073.80 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $467.74 Typical High $776.25 | Professional | 81 · Minimal assistant surgeon | $389.05 | $467.74 | $776.25 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $467.74 Typical High $776.25 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $467.74 | $776.25 |
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
$3,162
AK $5,129TX $977
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.