How much rates vary
Facilitymedian $11,482 · 10th to 90th $1,202 to $18,197Professionalmedian $794 · 10th to 90th $437 to $3,162
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 $436.52 Median $8,317.64 Typical High $14,454.40 | Facility | None | $436.52 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $3,548.13 | Professional | None | $426.58 | $436.52 | $3,548.13 |
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 $446.68 Median $1,288.25 Typical High $3,162.28 | Professional | None | $446.68 | $1,288.25 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $812.83 Typical High $1,995.26 | Professional | 62 · Two surgeons | $275.42 | $812.83 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $204.17 Typical High $512.86 | Professional | 80 · Assistant surgeon | $70.79 | $204.17 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $181.97 Typical High $446.68 | Professional | AS · PA/NP assist | $61.66 | $181.97 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,737.80 | Facility | None | $1,023.29 | $1,174.90 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,548.82 | Professional | None | $616.60 | $741.31 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $457.09 Median $8,128.31 Typical High $15,135.61 | Facility | None | $457.09 | $8,128.31 | $15,135.61 |
DeanCare Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,348.96 | Professional | None | $691.83 | $812.83 | $1,348.96 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $851.14 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $851.14 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $218.78 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $190.55 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $190.55 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $12,302.69 Typical High $15,848.93 | Facility | None | $794.33 | $12,302.69 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,380.38 Typical High $3,388.44 | Professional | None | $478.63 | $1,380.38 | $3,388.44 |
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 $549.54 Median $912.01 Typical High $1,202.26 | Professional | None | $549.54 | $912.01 | $1,202.26 |
Prevea360 Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $851.14 | Facility | None | $363.08 | $457.09 | $851.14 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $1,698.24 | Professional | None | $426.58 | $891.25 | $1,698.24 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $912.01 | Professional | None | $616.60 | $741.31 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,737.80 | $2,187.76 |
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 $426.58 Median $724.44 Typical High $1,862.09 | Professional | None | $426.58 | $724.44 | $1,862.09 |
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 $323.59 Median $323.59 Typical High $2,630.27 | Professional | 54 · Surgery only | $323.59 | $323.59 | $2,630.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $2,454.71 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $346.74 Median $407.38 Typical High $676.08 | Professional | 51 · Multiple procedures | $346.74 | $407.38 | $676.08 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $1,096.48 | Professional | 54 · Surgery only | $549.54 | $645.65 | $1,096.48 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $269.15 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $269.15 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $676.08 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $575.44 | $676.08 | $1,148.15 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | 81 · Minimal assistant surgeon | $109.65 | $128.82 | $218.78 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $109.65 Median $128.82 Typical High $218.78 | Professional | 82 · Assistant surgeon, no resident | $109.65 | $128.82 | $218.78 |
Where Wisconsin sits
The same service costs 4.4 times more in Alaska 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· 5th of 51
$912
AK $1,318UT $302
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.