How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $2,630 · 10th to 90th $1,445 to $9,772
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 $1,445.44 Median $1,445.44 Typical High $14,454.40 | Facility | None | $1,445.44 | $1,445.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $12,302.69 | Professional | None | $1,445.44 | $1,445.44 | $12,302.69 |
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 $1,318.26 Median $4,265.80 Typical High $10,232.93 | Professional | None | $1,318.26 | $4,265.80 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $2,691.53 Typical High $6,456.54 | Professional | 62 · Two surgeons | $831.76 | $2,691.53 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $676.08 Typical High $1,621.81 | Professional | 80 · Assistant surgeon | $208.93 | $676.08 | $1,621.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $588.84 Typical High $1,412.54 | Professional | AS · PA/NP assist | $186.21 | $588.84 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,388.44 Typical High $5,128.61 | Facility | None | $812.83 | $3,388.44 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $5,370.32 | Professional | None | $1,659.59 | $2,454.71 | $5,370.32 |
DeanCare Setting Facility Modifier None Typical Low $1,445.44 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,445.44 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $4,466.84 | Professional | None | $2,238.72 | $2,630.27 | $4,466.84 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,659.59 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,412.54 | $1,659.59 | $2,818.38 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $707.95 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $707.95 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $371.54 Typical High $630.96 | Professional | AS · PA/NP assist | $316.23 | $371.54 | $630.96 |
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 $1,513.56 Median $4,897.79 Typical High $9,772.37 | Professional | None | $1,513.56 | $4,897.79 | $9,772.37 |
Network Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,630.27 | Facility | None | $1,905.46 | $2,089.30 | $2,630.27 |
Network Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,951.21 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,951.21 | $3,801.89 |
Prevea360 Setting Facility Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,513.56 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $1,412.54 Median $2,884.03 Typical High $5,495.41 | Professional | None | $1,412.54 | $2,884.03 | $5,495.41 |
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 $1,862.09 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,454.71 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,623.41 Typical High $7,244.36 | Professional | None | $3,235.94 | $5,623.41 | $7,244.36 |
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 $1,318.26 Median $2,238.72 Typical High $6,025.60 | Professional | None | $1,318.26 | $2,238.72 | $6,025.60 |
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 $707.95 Median $707.95 Typical High $6,165.95 | Professional | 52 · Reduced service | $707.95 | $707.95 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $2,454.71 | Professional | 53 · Discontinued | $288.40 | $288.40 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $9,332.54 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $1,862.09 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $8,709.64 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,318.26 Typical High $2,238.72 | Professional | 51 · Multiple procedures | $1,122.02 | $1,318.26 | $2,238.72 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,137.96 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,819.70 | $2,137.96 | $3,548.13 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $524.81 Typical High $891.25 | Professional | 55 · Aftercare only | $446.68 | $524.81 | $891.25 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,238.72 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,238.72 | $3,715.35 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $426.58 Typical High $707.95 | Professional | 81 · Minimal assistant surgeon | $363.08 | $426.58 | $707.95 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $426.58 Typical High $707.95 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $426.58 | $707.95 |
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· 5th of 51
$2,884
AK $4,677TX $871
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.