How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $2,089 · 10th to 90th $1,122 to $7,762
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 $1,122.02 Median $1,122.02 Typical High $14,454.40 | Facility | None | $1,122.02 | $1,122.02 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $9,772.37 | Professional | None | $1,122.02 | $1,122.02 | $9,772.37 |
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 $1,023.29 Median $3,311.31 Typical High $7,762.47 | Professional | None | $1,023.29 | $3,311.31 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $2,089.30 Typical High $4,897.79 | Professional | 62 · Two surgeons | $645.65 | $2,089.30 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $537.03 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $165.96 | $537.03 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $467.74 Typical High $1,096.48 | Professional | AS · PA/NP assist | $144.54 | $467.74 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $4,073.80 | Facility | None | $812.83 | $2,630.27 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $4,265.80 | Professional | None | $1,318.26 | $1,905.46 | $4,265.80 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,122.02 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,778.28 | $2,089.30 | $3,467.37 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,318.26 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,122.02 | $1,318.26 | $2,187.76 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $549.54 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $549.54 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $489.78 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $489.78 |
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 $1,202.26 Median $3,801.89 Typical High $7,762.47 | Professional | None | $1,202.26 | $3,801.89 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,089.30 | Facility | None | $1,513.56 | $2,041.74 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $2,951.21 | Professional | None | $1,412.54 | $2,290.87 | $2,951.21 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,187.76 | Facility | None | $933.25 | $1,202.26 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $2,290.87 Typical High $4,365.16 | Professional | None | $1,122.02 | $2,290.87 | $4,365.16 |
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 $1,445.44 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,905.46 | $2,344.23 |
Security Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $5,623.41 | Professional | None | $3,235.94 | $4,365.16 | $5,623.41 |
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 $1,047.13 Median $1,737.80 Typical High $4,677.35 | Professional | None | $1,047.13 | $1,737.80 | $4,677.35 |
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 $562.34 Median $562.34 Typical High $4,786.30 | Professional | 52 · Reduced service | $562.34 | $562.34 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $1,949.84 | Professional | 53 · Discontinued | $223.87 | $223.87 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $7,244.36 | Professional | 54 · Surgery only | $851.14 | $851.14 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $1,445.44 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $977.24 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $6,760.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,047.13 Typical High $1,737.80 | Professional | 51 · Multiple procedures | $891.25 | $1,047.13 | $1,737.80 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,659.59 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,412.54 | $1,659.59 | $2,754.23 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $416.87 Typical High $691.83 | Professional | 55 · Aftercare only | $354.81 | $416.87 | $691.83 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,737.80 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,737.80 | $2,884.03 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $281.84 Median $331.13 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $281.84 | $331.13 | $549.54 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $281.84 Median $331.13 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $281.84 | $331.13 | $549.54 |
Where Wisconsin sits
The same service costs 24.5 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· 5th of 51
$2,291
AK $4,266TX $174
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.