How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $18,197Professionalmedian $2,570 · 10th to 90th $955 to $6,918
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 $954.99 Median $954.99 Typical High $14,454.40 | Facility | None | $954.99 | $954.99 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $10,964.78 | Professional | None | $954.99 | $954.99 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $19,054.61 | Facility | None | $6,309.57 | $10,715.19 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $3,801.89 Typical High $6,918.31 | Professional | None | $977.24 | $3,801.89 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $5,623.41 Typical High $10,232.93 | Professional | 50 · Both sides | $1,479.11 | $5,623.41 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $2,398.83 Typical High $4,365.16 | Professional | 62 · Two surgeons | $616.60 | $2,398.83 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $616.60 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $154.88 | $616.60 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $537.03 Typical High $954.99 | Professional | AS · PA/NP assist | $138.04 | $537.03 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $4,073.80 | Facility | None | $812.83 | $2,691.53 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,659.59 | $1,949.84 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,122.02 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,778.28 | $2,187.76 | $3,019.95 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $3,311.31 Typical High $4,570.88 | Professional | 50 · Both sides | $2,691.53 | $3,311.31 | $4,570.88 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,380.38 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,122.02 | $1,380.38 | $1,905.46 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $478.63 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $478.63 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $309.03 Typical High $426.58 | Professional | AS · PA/NP assist | $251.19 | $309.03 | $426.58 |
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 $954.99 Median $2,630.27 Typical High $9,332.54 | Professional | None | $954.99 | $2,630.27 | $9,332.54 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,089.30 | Facility | None | $1,445.44 | $1,479.11 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,698.24 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,187.76 | Facility | None | $933.25 | $1,122.02 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,202.26 | $2,754.23 | $4,570.88 |
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 $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Security Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,786.30 Typical High $7,413.10 | Professional | None | $3,162.28 | $4,786.30 | $7,413.10 |
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 $933.25 Median $1,862.09 Typical High $5,754.40 | Professional | None | $933.25 | $1,862.09 | $5,754.40 |
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 $467.74 Median $467.74 Typical High $5,495.41 | Professional | 52 · Reduced service | $467.74 | $467.74 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $2,187.76 | Professional | 53 · Discontinued | $190.55 | $190.55 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $8,128.31 | Professional | 54 · Surgery only | $707.95 | $707.95 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $1,659.59 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $7,585.78 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,096.48 Typical High $1,513.56 | Professional | 51 · Multiple procedures | $891.25 | $1,096.48 | $1,513.56 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,737.80 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,445.44 | $1,737.80 | $2,398.83 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $436.52 Typical High $602.56 | Professional | 55 · Aftercare only | $354.81 | $436.52 | $602.56 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,862.09 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,862.09 | $2,511.89 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $354.81 Typical High $478.63 | Professional | 81 · Minimal assistant surgeon | $288.40 | $354.81 | $478.63 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $354.81 Typical High $478.63 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $354.81 | $478.63 |
Where Wisconsin sits
The same service costs 21.9 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
$3,020
AK $4,467TX $204
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.