How much rates vary
Facilitymedian $7,943 · 10th to 90th $813 to $19,498Professionalmedian $4,571 · 10th to 90th $1,660 to $11,749
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 $1,584.89 Median $1,584.89 Typical High $14,454.40 | Facility | None | $1,584.89 | $1,584.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $16,595.87 | Professional | None | $1,584.89 | $1,584.89 | $16,595.87 |
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 $1,659.59 Median $6,456.54 Typical High $11,748.98 | Professional | None | $1,659.59 | $6,456.54 | $11,748.98 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $4,073.80 Typical High $7,413.10 | Professional | 62 · Two surgeons | $1,023.29 | $4,073.80 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $1,023.29 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $263.03 | $1,023.29 | $1,862.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $912.01 Typical High $1,621.81 | Professional | AS · PA/NP assist | $229.09 | $912.01 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,466.84 Typical High $6,918.31 | Facility | None | $812.83 | $4,466.84 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $7,762.47 | Professional | None | $2,818.38 | $3,311.31 | $7,762.47 |
DeanCare Setting Facility Modifier None Typical Low $1,905.46 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,905.46 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,019.95 Median $3,715.35 Typical High $5,370.32 | Professional | None | $3,019.95 | $3,715.35 | $5,370.32 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,905.46 | $2,344.23 | $3,388.44 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $588.84 Typical High $851.14 | Professional | 80 · Assistant surgeon | $478.63 | $588.84 | $851.14 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $524.81 Typical High $741.31 | Professional | AS · PA/NP assist | $426.58 | $524.81 | $741.31 |
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 $1,905.46 Median $5,011.87 Typical High $13,182.57 | Professional | None | $1,905.46 | $5,011.87 | $13,182.57 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,548.13 | Facility | None | $2,089.30 | $2,511.89 | $3,548.13 |
Network Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,981.07 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,981.07 | $5,248.07 |
Prevea360 Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,715.35 | Facility | None | $1,584.89 | $2,041.74 | $3,715.35 |
Quartz Setting Professional Modifier None Typical Low $2,041.74 Median $4,677.35 Typical High $7,762.47 | Professional | None | $2,041.74 | $4,677.35 | $7,762.47 |
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 $3,311.31 Median $3,311.31 Typical High $4,265.80 | Professional | None | $3,311.31 | $3,311.31 | $4,265.80 |
Security Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Security Health Setting Professional Modifier None Typical Low $5,888.44 Median $9,772.37 Typical High $12,589.25 | Professional | None | $5,888.44 | $9,772.37 | $12,589.25 |
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 $1,819.70 Median $3,162.28 Typical High $9,772.37 | Professional | None | $1,819.70 | $3,162.28 | $9,772.37 |
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 $794.33 Median $794.33 Typical High $8,317.64 | Professional | 52 · Reduced service | $794.33 | $794.33 | $8,317.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $3,311.31 | Professional | 53 · Discontinued | $323.59 | $323.59 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $12,589.25 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $12,589.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $2,511.89 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $2,511.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $1,659.59 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $1,659.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $11,748.98 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $11,748.98 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | 51 · Multiple procedures | $1,513.56 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,951.21 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,398.83 | $2,951.21 | $4,265.80 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $741.31 Typical High $1,071.52 | Professional | 55 · Aftercare only | $602.56 | $741.31 | $1,071.52 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $3,090.30 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,511.89 | $3,090.30 | $4,466.84 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $478.63 Median $588.84 Typical High $851.14 | Professional | 81 · Minimal assistant surgeon | $478.63 | $588.84 | $851.14 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $478.63 Median $588.84 Typical High $851.14 | Professional | 82 · Assistant surgeon, no resident | $478.63 | $588.84 | $851.14 |
Where Wisconsin sits
The same service costs 22.9 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
$4,898
AK $7,586TX $331
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.