How much rates vary
Facilitymedian $7,244 · 10th to 90th $813 to $18,197Professionalmedian $1,514 · 10th to 90th $832 to $5,623
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 $831.76 Median $11,220.18 Typical High $14,454.40 | Facility | None | $831.76 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $9,120.11 | Professional | None | $831.76 | $831.76 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,589.25 Typical High $20,892.96 | Facility | None | $9,120.11 | $12,589.25 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $2,454.71 Typical High $5,888.44 | Professional | None | $758.58 | $2,454.71 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $1,548.82 Typical High $3,715.35 | Professional | 62 · Two surgeons | $478.63 | $1,548.82 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $389.05 Typical High $933.25 | Professional | 80 · Assistant surgeon | $120.23 | $389.05 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $338.84 Typical High $812.83 | Professional | AS · PA/NP assist | $104.71 | $338.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,949.84 Typical High $3,311.31 | Facility | None | $831.76 | $1,949.84 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,023.29 | $1,412.54 | $3,090.30 |
DeanCare Setting Facility Modifier None Typical Low $812.83 Median $8,128.31 Typical High $14,791.08 | Facility | None | $812.83 | $8,128.31 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,513.56 | $2,570.40 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,621.81 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,621.81 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $407.38 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $407.38 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $354.81 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $2,454.71 Typical High $18,197.01 | Facility | None | $512.86 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $2,818.38 Typical High $5,623.41 | Professional | None | $891.25 | $2,818.38 | $5,623.41 |
Network Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,096.48 | $1,513.56 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,698.24 | $2,187.76 |
Prevea360 Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,584.89 | Facility | None | $676.08 | $870.96 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $1,698.24 Typical High $3,162.28 | Professional | None | $812.83 | $1,698.24 | $3,162.28 |
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 $1,047.13 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,412.54 | $1,698.24 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $4,073.80 | Professional | None | $2,398.83 | $3,235.94 | $4,073.80 |
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 $794.33 Median $1,288.25 Typical High $3,388.44 | Professional | None | $794.33 | $1,288.25 | $3,388.44 |
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 $407.38 Median $407.38 Typical High $4,570.88 | Professional | 52 · Reduced service | $407.38 | $407.38 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,819.70 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $6,918.31 | Professional | 54 · Surgery only | $616.60 | $616.60 | $6,918.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $1,380.38 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $912.01 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $6,456.54 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $645.65 Median $758.58 Typical High $1,288.25 | Professional | 51 · Multiple procedures | $645.65 | $758.58 | $1,288.25 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,230.27 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,047.13 | $1,230.27 | $2,041.74 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $512.86 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $512.86 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,288.25 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,288.25 | $2,137.96 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $208.93 Median $245.47 Typical High $407.38 | Professional | 81 · Minimal assistant surgeon | $208.93 | $245.47 | $407.38 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $208.93 Median $245.47 Typical High $407.38 | Professional | 82 · Assistant surgeon, no resident | $208.93 | $245.47 | $407.38 |
Where Wisconsin sits
The same service costs 5.9 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· 4th of 51
$1,698
AK $3,162TX $537
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.