How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $2,239 · 10th to 90th $1,230 to $8,318
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 $1,230.27 Median $1,230.27 Typical High $14,454.40 | Facility | None | $1,230.27 | $1,230.27 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $10,471.29 | Professional | None | $1,230.27 | $1,230.27 | $10,471.29 |
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 $1,122.02 Median $3,630.78 Typical High $8,709.64 | Professional | None | $1,122.02 | $3,630.78 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $2,290.87 Typical High $5,495.41 | Professional | 62 · Two surgeons | $724.44 | $2,290.87 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $575.44 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $181.97 | $575.44 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $512.86 Typical High $1,202.26 | Professional | AS · PA/NP assist | $158.49 | $512.86 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,466.84 | Facility | None | $812.83 | $2,884.03 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $4,677.35 | Professional | None | $1,412.54 | $2,089.30 | $4,677.35 |
DeanCare Setting Facility Modifier None Typical Low $1,230.27 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,230.27 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,290.87 | $3,801.89 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,445.44 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,202.26 | $1,445.44 | $2,398.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $363.08 Typical High $602.56 | Professional | 80 · Assistant surgeon | $309.03 | $363.08 | $602.56 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $537.03 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $537.03 |
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 $1,288.25 Median $4,168.69 Typical High $8,317.64 | Professional | None | $1,288.25 | $4,168.69 | $8,317.64 |
Network Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,238.72 | Facility | None | $1,621.81 | $2,089.30 | $2,238.72 |
Network Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $3,235.94 | Professional | None | $1,548.82 | $2,511.89 | $3,235.94 |
Prevea360 Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,344.23 | Facility | None | $1,000.00 | $1,288.25 | $2,344.23 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $2,511.89 Typical High $4,786.30 | Professional | None | $1,202.26 | $2,511.89 | $4,786.30 |
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 $1,584.89 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,584.89 | $2,089.30 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,786.30 Typical High $6,165.95 | Professional | None | $2,570.40 | $4,786.30 | $6,165.95 |
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 $1,122.02 Median $1,905.46 Typical High $5,128.61 | Professional | None | $1,122.02 | $1,905.46 | $5,128.61 |
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 $616.60 Median $616.60 Typical High $5,248.07 | Professional | 52 · Reduced service | $616.60 | $616.60 | $5,248.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $2,089.30 | Professional | 53 · Discontinued | $245.47 | $245.47 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $7,943.28 | Professional | 54 · Surgery only | $912.01 | $912.01 | $7,943.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $1,584.89 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $1,584.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $7,413.10 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $7,413.10 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $954.99 Median $1,122.02 Typical High $1,905.46 | Professional | 51 · Multiple procedures | $954.99 | $1,122.02 | $1,905.46 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $3,019.95 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $457.09 Typical High $758.58 | Professional | 55 · Aftercare only | $389.05 | $457.09 | $758.58 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,905.46 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,905.46 | $3,162.28 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $309.03 Median $363.08 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $309.03 | $363.08 | $602.56 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $309.03 Median $363.08 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $309.03 | $363.08 | $602.56 |
Where Wisconsin sits
The same service costs 5.6 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
$2,512
AK $4,266TX $759
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.