How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,047 to $7,079Professionalmedian $2,818 · 10th to 90th $1,047 to $7,244
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 $1,047.13 Median $1,047.13 Typical High $14,454.40 | Facility | None | $1,047.13 | $1,047.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $9,772.37 | Professional | None | $1,047.13 | $1,047.13 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $3,981.07 Typical High $6,918.31 | Professional | None | $1,071.52 | $3,981.07 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $5,888.44 Typical High $10,232.93 | Professional | 50 · Both sides | $1,621.81 | $5,888.44 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $2,511.89 Typical High $4,365.16 | Professional | 62 · Two surgeons | $676.08 | $2,511.89 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $645.65 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $169.82 | $645.65 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $562.34 Typical High $954.99 | Professional | AS · PA/NP assist | $151.36 | $562.34 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,023.29 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $5,011.87 | Professional | None | $1,819.70 | $2,137.96 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $1,230.27 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,230.27 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,398.83 | $3,311.31 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,630.78 Typical High $4,897.79 | Professional | 50 · Both sides | $2,951.21 | $3,630.78 | $4,897.79 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,513.56 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,230.27 | $1,513.56 | $2,089.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $389.05 Typical High $524.81 | Professional | 80 · Assistant surgeon | $316.23 | $389.05 | $524.81 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $338.84 Typical High $457.09 | Professional | AS · PA/NP assist | $275.42 | $338.84 | $457.09 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $2,398.83 Typical High $6,165.95 | Facility | None | $660.69 | $2,398.83 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $3,019.95 Typical High $9,549.93 | Professional | None | $1,071.52 | $3,019.95 | $9,549.93 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,819.70 | $2,818.38 |
Prevea360 Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,454.71 | Facility | None | $1,023.29 | $1,258.93 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $4,897.79 | Professional | None | $1,318.26 | $3,019.95 | $4,897.79 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $2,754.23 | Facility | None | $812.83 | $1,737.80 | $2,754.23 |
Quartz Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,137.96 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Security Health Setting Professional Modifier None Typical Low $3,162.28 Median $5,248.07 Typical High $8,128.31 | Professional | None | $3,162.28 | $5,248.07 | $8,128.31 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $6,309.57 | Professional | None | $1,047.13 | $1,995.26 | $6,309.57 |
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 $512.86 Median $512.86 Typical High $4,786.30 | Professional | 52 · Reduced service | $512.86 | $512.86 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $1,949.84 | Professional | 53 · Discontinued | $208.93 | $208.93 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $7,244.36 | Professional | 54 · Surgery only | $776.25 | $776.25 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $1,445.44 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $977.24 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $6,760.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $977.24 Median $1,202.26 Typical High $1,659.59 | Professional | 51 · Multiple procedures | $977.24 | $1,202.26 | $1,659.59 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,905.46 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,548.82 | $1,905.46 | $2,630.27 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $478.63 Typical High $660.69 | Professional | 55 · Aftercare only | $389.05 | $478.63 | $660.69 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,041.74 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,041.74 | $2,754.23 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $316.23 Median $389.05 Typical High $524.81 | Professional | 81 · Minimal assistant surgeon | $316.23 | $389.05 | $524.81 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $316.23 Median $389.05 Typical High $524.81 | Professional | 82 · Assistant surgeon, no resident | $316.23 | $389.05 | $524.81 |
Where Wisconsin sits
The same service costs 5.8 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
$3,020
AK $4,898TX $851
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.