How much rates vary
Facilitymedian $11,482 · 10th to 90th $1,122 to $18,197Professionalmedian $759 · 10th to 90th $407 to $2,951
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 $407.38 Median $8,317.64 Typical High $14,454.40 | Facility | None | $407.38 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $3,467.37 | Professional | None | $389.05 | $407.38 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $12,302.69 Typical High $20,417.38 | Facility | None | $7,079.46 | $12,302.69 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $1,202.26 Typical High $2,951.21 | Professional | None | $426.58 | $1,202.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $758.58 Typical High $1,862.09 | Professional | 62 · Two surgeons | $269.15 | $758.58 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $190.55 Typical High $478.63 | Professional | 80 · Assistant surgeon | $67.61 | $190.55 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $165.96 Typical High $416.87 | Professional | AS · PA/NP assist | $60.26 | $165.96 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,621.81 | Facility | None | $954.99 | $1,096.48 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,445.44 | Professional | None | $575.44 | $691.83 | $1,445.44 |
DeanCare Setting Facility Modifier None Typical Low $436.52 Median $8,128.31 Typical High $15,135.61 | Facility | None | $436.52 | $8,128.31 | $15,135.61 |
DeanCare Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,288.25 | Professional | None | $645.65 | $758.58 | $1,288.25 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $812.83 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $812.83 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $204.17 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $204.17 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $177.83 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $177.83 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $12,022.64 Typical High $15,848.93 | Facility | None | $741.31 | $12,022.64 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $1,288.25 Typical High $3,162.28 | Professional | None | $446.68 | $1,288.25 | $3,162.28 |
Network Health Setting Facility Modifier None Typical Low $8,317.64 Median $9,549.93 Typical High $15,848.93 | Facility | None | $8,317.64 | $9,549.93 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $512.86 Median $870.96 Typical High $1,122.02 | Professional | None | $512.86 | $870.96 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $794.33 | Facility | None | $338.84 | $436.52 | $794.33 |
Quartz Setting Professional Modifier None Typical Low $407.38 Median $831.76 Typical High $1,584.89 | Professional | None | $407.38 | $831.76 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $851.14 | Professional | None | $575.44 | $691.83 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,621.81 | $2,041.74 |
The Alliance Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $12,302.69 Typical High $16,218.10 | Facility | None | $7,943.28 | $12,302.69 | $16,218.10 |
United Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $1,737.80 | Professional | None | $407.38 | $676.08 | $1,737.80 |
8 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 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $2,630.27 | Professional | 54 · Surgery only | $309.03 | $309.03 | $2,630.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $2,454.71 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $323.59 Median $380.19 Typical High $645.65 | Professional | 51 · Multiple procedures | $323.59 | $380.19 | $645.65 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $1,023.29 | Professional | 54 · Surgery only | $512.86 | $602.56 | $1,023.29 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $151.36 Typical High $257.04 | Professional | 55 · Aftercare only | $128.82 | $151.36 | $257.04 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $1,071.52 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $102.33 Median $120.23 Typical High $204.17 | Professional | 81 · Minimal assistant surgeon | $102.33 | $120.23 | $204.17 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $102.33 Median $120.23 Typical High $204.17 | Professional | 82 · Assistant surgeon, no resident | $102.33 | $120.23 | $204.17 |
Where Wisconsin sits
The same service costs 4.2 times more in Wyoming than in Utah. 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
$851
WY $1,202UT $288
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.