How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,096 to $11,220Professionalmedian $1,000 · 10th to 90th $562 to $4,074
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 $562.34 Median $8,317.64 Typical High $14,454.40 | Facility | None | $562.34 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $4,168.69 | Professional | None | $524.81 | $562.34 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $1,659.59 Typical High $3,890.45 | Professional | None | $524.81 | $1,659.59 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $2,454.71 Typical High $5,888.44 | Professional | 50 · Both sides | $794.33 | $2,454.71 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $1,047.13 Typical High $2,454.71 | Professional | 62 · Two surgeons | $331.13 | $1,047.13 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $263.03 Typical High $630.96 | Professional | 80 · Assistant surgeon | $85.11 | $263.03 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $229.09 Typical High $549.54 | Professional | AS · PA/NP assist | $74.13 | $229.09 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $741.31 | Professional | None | $489.78 | $501.19 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $4,786.30 | Facility | None | $1,174.90 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $2,137.96 | Professional | None | $645.65 | $954.99 | $2,137.96 |
DeanCare Setting Facility Modifier None Typical Low $588.84 Median $5,128.61 Typical High $9,332.54 | Facility | None | $588.84 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,698.24 | Professional | None | $891.25 | $1,047.13 | $1,698.24 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $2,570.40 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $2,570.40 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,071.52 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,071.52 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $275.42 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $275.42 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $239.88 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $239.88 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $5,754.40 Typical High $10,964.78 | Facility | None | $933.25 | $5,754.40 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,905.46 Typical High $4,073.80 | Professional | None | $588.84 | $1,905.46 | $4,073.80 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,445.44 | Professional | None | $691.83 | $1,122.02 | $1,445.44 |
Prevea360 Setting Facility Modifier None Typical Low $562.34 Median $645.65 Typical High $1,023.29 | Facility | None | $562.34 | $645.65 | $1,023.29 |
Quartz Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,187.76 | Professional | None | $562.34 | $1,148.15 | $2,187.76 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $5,011.87 | Facility | None | $933.25 | $3,162.28 | $5,011.87 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,202.26 | Professional | None | $588.84 | $954.99 | $1,202.26 |
Security Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,137.96 | $2,754.23 |
The Alliance Setting Professional Modifier None Typical Low $1,698.24 Median $2,951.21 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,951.21 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $2,290.87 | Professional | None | $512.86 | $851.14 | $2,290.87 |
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 $281.84 Median $281.84 Typical High $2,454.71 | Professional | 52 · Reduced service | $281.84 | $281.84 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $977.24 | Professional | 53 · Discontinued | $112.20 | $112.20 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $3,715.35 | Professional | 54 · Surgery only | $416.87 | $416.87 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $741.31 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $489.78 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $3,467.37 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $446.68 Median $524.81 Typical High $851.14 | Professional | 51 · Multiple procedures | $446.68 | $524.81 | $851.14 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $831.76 Typical High $1,380.38 | Professional | 54 · Surgery only | $707.95 | $831.76 | $1,380.38 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $338.84 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $338.84 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $870.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $741.31 | $870.96 | $1,445.44 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $141.25 Median $165.96 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $141.25 | $165.96 | $275.42 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $141.25 Median $165.96 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $141.25 | $165.96 | $275.42 |
Where Wisconsin sits
The same service costs 5.4 times more in Vermont than in Montana. 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.
Physician feeFacility fee
VT $9,112MT $1,703
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.