How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $3,548 · 10th to 90th $1,288 to $9,120
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 $1,230.27 Median $1,230.27 Typical High $14,454.40 | Facility | None | $1,230.27 | $1,230.27 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $12,882.50 | Professional | None | $1,230.27 | $1,230.27 | $12,882.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,128.31 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,128.31 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $5,128.61 Typical High $9,120.11 | Professional | None | $1,288.25 | $5,128.61 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $3,162.28 Typical High $5,754.40 | Professional | 62 · Two surgeons | $812.83 | $3,162.28 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $812.83 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $245.47 | $812.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $707.95 Typical High $1,258.93 | Professional | AS · PA/NP assist | $181.97 | $707.95 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,548.13 Typical High $5,370.32 | Facility | None | $812.83 | $3,548.13 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $6,025.60 | Professional | None | $2,187.76 | $2,570.40 | $6,025.60 |
DeanCare Setting Facility Modifier None Typical Low $1,479.11 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,479.11 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,884.03 | $4,168.69 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,819.70 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,479.11 | $1,819.70 | $2,630.27 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $457.09 Typical High $660.69 | Professional | 80 · Assistant surgeon | $380.19 | $457.09 | $660.69 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $407.38 Typical High $588.84 | Professional | AS · PA/NP assist | $331.13 | $407.38 | $588.84 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $3,890.45 Typical High $10,232.93 | Professional | None | $1,479.11 | $3,890.45 | $10,232.93 |
Network Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,754.23 | Facility | None | $1,949.84 | $2,089.30 | $2,754.23 |
Network Health Setting Professional Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $4,073.80 | Professional | None | $1,659.59 | $3,090.30 | $4,073.80 |
Prevea360 Setting Facility Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $3,019.95 | Facility | None | $1,230.27 | $1,584.89 | $3,019.95 |
Quartz Setting Professional Modifier None Typical Low $1,584.89 Median $3,630.78 Typical High $5,888.44 | Professional | None | $1,584.89 | $3,630.78 | $5,888.44 |
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 $2,570.40 Median $2,570.40 Typical High $3,235.94 | Professional | None | $2,570.40 | $2,570.40 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $7,585.78 Typical High $9,772.37 | Professional | None | $4,466.84 | $7,585.78 | $9,772.37 |
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 $1,445.44 Median $2,454.71 Typical High $7,585.78 | Professional | None | $1,445.44 | $2,454.71 | $7,585.78 |
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 $616.60 Median $616.60 Typical High $6,456.54 | Professional | 52 · Reduced service | $616.60 | $616.60 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $2,570.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $9,772.37 | Professional | 54 · Surgery only | $933.25 | $933.25 | $9,772.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $1,949.84 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $1,949.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $9,120.11 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $9,120.11 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,174.90 Median $1,445.44 Typical High $2,089.30 | Professional | 51 · Multiple procedures | $1,174.90 | $1,445.44 | $2,089.30 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,290.87 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,862.09 | $2,290.87 | $3,311.31 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $575.44 Typical High $831.76 | Professional | 55 · Aftercare only | $467.74 | $575.44 | $831.76 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,398.83 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,398.83 | $3,467.37 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $380.19 Median $457.09 Typical High $660.69 | Professional | 81 · Minimal assistant surgeon | $380.19 | $457.09 | $660.69 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $380.19 Median $457.09 Typical High $660.69 | Professional | 82 · Assistant surgeon, no resident | $380.19 | $457.09 | $660.69 |
Where Wisconsin sits
The same service costs 5.9 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
$3,890
AK $5,888TX $1,000
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.