How much rates vary
Facilitymedian $7,943 · 10th to 90th $933 to $19,498Professionalmedian $4,266 · 10th to 90th $1,514 to $10,715
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 $1,479.11 Median $1,479.11 Typical High $14,454.40 | Facility | None | $1,479.11 | $1,479.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $18,620.87 | Professional | None | $1,479.11 | $1,479.11 | $18,620.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $15,488.17 Typical High $26,302.68 | Facility | None | $10,964.78 | $15,488.17 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $6,025.60 Typical High $10,715.19 | Professional | None | $1,513.56 | $6,025.60 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $3,715.35 Typical High $6,760.83 | Professional | 62 · Two surgeons | $954.99 | $3,715.35 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $954.99 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $239.88 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $831.76 Typical High $1,513.56 | Professional | AS · PA/NP assist | $208.93 | $831.76 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $4,168.69 Typical High $7,079.46 | Facility | None | $1,698.24 | $4,168.69 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $7,079.46 | Professional | None | $2,630.27 | $3,019.95 | $7,079.46 |
DeanCare Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,737.80 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $4,897.79 | Professional | None | $2,754.23 | $3,388.44 | $4,897.79 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,137.96 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,737.80 | $2,137.96 | $3,090.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 80 · Assistant surgeon | $446.68 | $549.54 | $794.33 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $478.63 Typical High $691.83 | Professional | AS · PA/NP assist | $389.05 | $478.63 | $691.83 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $2,691.53 Typical High $18,197.01 | Facility | None | $512.86 | $2,691.53 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $4,677.35 Typical High $12,302.69 | Professional | None | $1,778.28 | $4,677.35 | $12,302.69 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,235.94 | Facility | None | $2,089.30 | $2,344.23 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,715.35 Typical High $4,786.30 | Professional | None | $1,949.84 | $3,715.35 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,235.94 | Facility | None | $1,445.44 | $1,862.09 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $1,862.09 Median $4,265.80 Typical High $7,079.46 | Professional | None | $1,862.09 | $4,265.80 | $7,079.46 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,511.89 Typical High $7,244.36 | Facility | None | $812.83 | $2,511.89 | $7,244.36 |
Quartz Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,630.78 | Professional | None | $3,019.95 | $3,019.95 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Security Health Setting Professional Modifier None Typical Low $5,128.61 Median $9,120.11 Typical High $11,481.54 | Professional | None | $5,128.61 | $9,120.11 | $11,481.54 |
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 $1,698.24 Median $2,884.03 Typical High $8,912.51 | Professional | None | $1,698.24 | $2,884.03 | $8,912.51 |
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 $741.31 Median $741.31 Typical High $9,332.54 | Professional | 52 · Reduced service | $741.31 | $741.31 | $9,332.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $3,715.35 | Professional | 53 · Discontinued | $295.12 | $295.12 | $3,715.35 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $13,803.84 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $13,803.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $2,818.38 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $2,818.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $1,862.09 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $1,862.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $12,882.50 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $12,882.50 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,380.38 Median $1,698.24 Typical High $2,454.71 | Professional | 51 · Multiple procedures | $1,380.38 | $1,698.24 | $2,454.71 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,754.23 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,238.72 | $2,754.23 | $3,981.07 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $676.08 Typical High $977.24 | Professional | 55 · Aftercare only | $562.34 | $676.08 | $977.24 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,884.03 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,884.03 | $4,168.69 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 81 · Minimal assistant surgeon | $446.68 | $549.54 | $794.33 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 82 · Assistant surgeon, no resident | $446.68 | $549.54 | $794.33 |
Where Wisconsin sits
The same service costs 6.0 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· 2nd of 51
$4,571
AK $7,079TX $1,175
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.