How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $2,570 · 10th to 90th $1,380 to $9,550
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 $1,380.38 Median $1,380.38 Typical High $14,454.40 | Facility | None | $1,380.38 | $1,380.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $12,022.64 | Professional | None | $1,380.38 | $1,380.38 | $12,022.64 |
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 $1,288.25 Median $4,073.80 Typical High $9,772.37 | Professional | None | $1,288.25 | $4,073.80 | $9,772.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $2,630.27 Typical High $6,165.95 | Professional | 62 · Two surgeons | $812.83 | $2,630.27 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $660.69 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $204.17 | $660.69 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $575.44 Typical High $1,380.38 | Professional | AS · PA/NP assist | $177.83 | $575.44 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,235.94 Typical High $5,011.87 | Facility | None | $812.83 | $3,235.94 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $5,248.07 | Professional | None | $1,584.89 | $2,344.23 | $5,248.07 |
DeanCare Setting Facility Modifier None Typical Low $1,380.38 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,380.38 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,570.40 | $4,365.16 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,621.81 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,380.38 | $1,621.81 | $2,754.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $407.38 Typical High $691.83 | Professional | 80 · Assistant surgeon | $346.74 | $407.38 | $691.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $363.08 Typical High $602.56 | Professional | AS · PA/NP assist | $309.03 | $363.08 | $602.56 |
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 $1,479.11 Median $4,786.30 Typical High $9,549.93 | Professional | None | $1,479.11 | $4,786.30 | $9,549.93 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,570.40 | Facility | None | $1,862.09 | $2,089.30 | $2,570.40 |
Network Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,884.03 | $3,630.78 |
Prevea360 Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,691.53 | Facility | None | $1,148.15 | $1,479.11 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,380.38 Median $2,818.38 Typical High $5,370.32 | Professional | None | $1,380.38 | $2,818.38 | $5,370.32 |
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 $1,778.28 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,778.28 | $2,344.23 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,073.80 Median $5,370.32 Typical High $6,918.31 | Professional | None | $4,073.80 | $5,370.32 | $6,918.31 |
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 $1,288.25 Median $2,137.96 Typical High $5,754.40 | Professional | None | $1,288.25 | $2,137.96 | $5,754.40 |
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 $691.83 Median $691.83 Typical High $6,025.60 | Professional | 52 · Reduced service | $691.83 | $691.83 | $6,025.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $2,398.83 | Professional | 53 · Discontinued | $275.42 | $275.42 | $2,398.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $8,912.51 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $8,912.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $1,778.28 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $1,778.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $8,317.64 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $8,317.64 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,288.25 Typical High $2,187.76 | Professional | 51 · Multiple procedures | $1,096.48 | $1,288.25 | $2,187.76 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,041.74 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,737.80 | $2,041.74 | $3,467.37 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $512.86 Typical High $870.96 | Professional | 55 · Aftercare only | $436.52 | $512.86 | $870.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,137.96 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,137.96 | $3,630.78 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $346.74 Median $407.38 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $346.74 | $407.38 | $691.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $346.74 Median $407.38 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $346.74 | $407.38 | $691.83 |
Where Wisconsin sits
The same service costs 21.4 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
$2,818
AK $4,571TX $214
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.