How much rates vary
Facilitymedian $5,248 · 10th to 90th $813 to $16,218Professionalmedian $3,388 · 10th to 90th $1,820 to $12,589
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $15,848.93 | Professional | None | $1,819.70 | $1,819.70 | $15,848.93 |
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 $1,698.24 Median $5,495.41 Typical High $12,882.50 | Professional | None | $1,698.24 | $5,495.41 | $12,882.50 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $851.14 Typical High $2,089.30 | Professional | 80 · Assistant surgeon | $269.15 | $851.14 | $2,089.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $758.58 Typical High $1,819.70 | Professional | AS · PA/NP assist | $234.42 | $758.58 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,265.80 Typical High $6,606.93 | Facility | None | $812.83 | $4,265.80 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $6,918.31 | Professional | None | $2,137.96 | $3,090.30 | $6,918.31 |
DeanCare Setting Facility Modifier None Typical Low $1,819.70 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,819.70 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,884.03 | $3,388.44 | $5,754.40 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 80 · Assistant surgeon | $457.09 | $537.03 | $912.01 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $478.63 Typical High $794.33 | Professional | AS · PA/NP assist | $398.11 | $478.63 | $794.33 |
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 $1,995.26 Median $6,309.57 Typical High $12,589.25 | Professional | None | $1,995.26 | $6,309.57 | $12,589.25 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,388.44 | Facility | None | $2,089.30 | $2,454.71 | $3,388.44 |
Network Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,801.89 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,801.89 | $4,897.79 |
Prevea360 Setting Facility Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,548.13 | Facility | None | $1,513.56 | $1,949.84 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $3,715.35 Typical High $7,079.46 | Professional | None | $1,778.28 | $3,715.35 | $7,079.46 |
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 $2,398.83 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,398.83 | $3,090.30 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $7,079.46 Typical High $9,120.11 | Professional | None | $5,370.32 | $7,079.46 | $9,120.11 |
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 $1,778.28 Median $2,884.03 Typical High $7,585.78 | Professional | None | $1,778.28 | $2,884.03 | $7,585.78 |
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 $912.01 Median $912.01 Typical High $7,762.47 | Professional | 52 · Reduced service | $912.01 | $912.01 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $3,162.28 | Professional | 53 · Discontinued | $363.08 | $363.08 | $3,162.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $11,748.98 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $11,748.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $2,344.23 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $1,584.89 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $10,964.78 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $10,964.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,445.44 Median $1,698.24 Typical High $2,884.03 | Professional | 51 · Multiple procedures | $1,445.44 | $1,698.24 | $2,884.03 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,691.53 Typical High $4,570.88 | Professional | 54 · Surgery only | $2,290.87 | $2,691.53 | $4,570.88 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $676.08 Typical High $1,148.15 | Professional | 55 · Aftercare only | $575.44 | $676.08 | $1,148.15 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,818.38 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,818.38 | $4,786.30 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 81 · Minimal assistant surgeon | $457.09 | $537.03 | $912.01 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $457.09 Median $537.03 Typical High $912.01 | Professional | 82 · Assistant surgeon, no resident | $457.09 | $537.03 | $912.01 |
Where Wisconsin sits
The same service costs 5.4 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
$3,631
AK $6,026TX $1,122
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.