How much rates vary
Facilitymedian $5,623 · 10th to 90th $813 to $16,218Professionalmedian $4,467 · 10th to 90th $2,399 to $16,596
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 $2,398.83 Median $2,398.83 Typical High $14,454.40 | Facility | None | $2,398.83 | $2,398.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $20,892.96 | Professional | None | $2,398.83 | $2,398.83 | $20,892.96 |
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 $2,238.72 Median $7,244.36 Typical High $17,378.01 | Professional | None | $2,238.72 | $7,244.36 | $17,378.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $4,570.88 Typical High $10,715.19 | Professional | 62 · Two surgeons | $1,412.54 | $4,570.88 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $1,148.15 Typical High $2,754.23 | Professional | 80 · Assistant surgeon | $354.81 | $1,148.15 | $2,754.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $1,000.00 Typical High $2,454.71 | Professional | AS · PA/NP assist | $316.23 | $1,000.00 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,623.41 Typical High $8,709.64 | Facility | None | $812.83 | $5,623.41 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $4,073.80 Typical High $9,120.11 | Professional | None | $2,818.38 | $4,073.80 | $9,120.11 |
DeanCare Setting Facility Modifier None Typical Low $2,398.83 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,398.83 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $7,585.78 | Professional | None | $3,801.89 | $4,466.84 | $7,585.78 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $2,818.38 Typical High $4,786.30 | Professional | 62 · Two surgeons | $2,398.83 | $2,818.38 | $4,786.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $707.95 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $602.56 | $707.95 | $1,230.27 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $630.96 Typical High $1,071.52 | Professional | AS · PA/NP assist | $537.03 | $630.96 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,630.27 Median $8,317.64 Typical High $16,595.87 | Professional | None | $2,630.27 | $8,317.64 | $16,595.87 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $4,466.84 | Facility | None | $2,089.30 | $3,235.94 | $4,466.84 |
Network Health Setting Professional Modifier None Typical Low $3,019.95 Median $5,011.87 Typical High $6,456.54 | Professional | None | $3,019.95 | $5,011.87 | $6,456.54 |
Prevea360 Setting Facility Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,786.30 | Facility | None | $1,995.26 | $2,570.40 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $2,344.23 Median $4,897.79 Typical High $9,332.54 | Professional | None | $2,344.23 | $4,897.79 | $9,332.54 |
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 $3,162.28 Median $4,073.80 Typical High $5,128.61 | Professional | None | $3,162.28 | $4,073.80 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Security Health Setting Professional Modifier None Typical Low $7,244.36 Median $9,549.93 Typical High $12,302.69 | Professional | None | $7,244.36 | $9,549.93 | $12,302.69 |
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 $2,290.87 Median $3,801.89 Typical High $10,232.93 | Professional | None | $2,290.87 | $3,801.89 | $10,232.93 |
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 $1,202.26 Median $1,202.26 Typical High $10,471.29 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $10,471.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $4,168.69 | Professional | 53 · Discontinued | $478.63 | $478.63 | $4,168.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $15,488.17 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $15,488.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $3,090.30 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $3,090.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $2,089.30 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $2,089.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $14,454.40 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $14,454.40 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,905.46 Median $2,238.72 Typical High $3,801.89 | Professional | 51 · Multiple procedures | $1,905.46 | $2,238.72 | $3,801.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,548.13 Typical High $6,165.95 | Professional | 54 · Surgery only | $3,019.95 | $3,548.13 | $6,165.95 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $891.25 Typical High $1,513.56 | Professional | 55 · Aftercare only | $758.58 | $891.25 | $1,513.56 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,715.35 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,715.35 | $6,456.54 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $602.56 Median $707.95 Typical High $1,230.27 | Professional | 81 · Minimal assistant surgeon | $602.56 | $707.95 | $1,230.27 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $602.56 Median $707.95 Typical High $1,230.27 | Professional | 82 · Assistant surgeon, no resident | $602.56 | $707.95 | $1,230.27 |
Where Wisconsin sits
The same service costs 22.4 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
$4,677
AK $7,943TX $355
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.