How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,202 to $15,849Professionalmedian $2,630 · 10th to 90th $1,000 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 $3,090.30 Typical High $14,454.40 | Facility | None | $954.99 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $10,000.00 | Professional | None | $954.99 | $954.99 | $10,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $3,890.45 Typical High $6,918.31 | Professional | None | $1,000.00 | $3,890.45 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $2,454.71 Typical High $4,365.16 | Professional | 62 · Two surgeons | $630.96 | $2,454.71 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $575.44 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $158.49 | $575.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $549.54 Typical High $977.24 | Professional | AS · PA/NP assist | $141.25 | $549.54 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $16,595.87 | Facility | None | $1,000.00 | $3,548.13 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,698.24 | $1,949.84 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $5,888.44 | Facility | None | $1,122.02 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,778.28 | $2,187.76 | $3,162.28 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,380.38 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,122.02 | $1,380.38 | $1,995.26 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $512.86 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | AS · PA/NP assist | $251.19 | $309.03 | $446.68 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,122.02 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $3,019.95 Typical High $7,762.47 | Professional | None | $1,148.15 | $3,019.95 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,398.83 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,398.83 | $3,090.30 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,089.30 | Facility | None | $933.25 | $1,122.02 | $2,089.30 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $4,570.88 | Professional | None | $1,071.52 | $2,454.71 | $4,570.88 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $10,964.78 Typical High $18,197.01 | Facility | None | $724.44 | $10,964.78 | $18,197.01 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,949.84 | $1,949.84 | $2,398.83 |
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 $3,548.13 Median $5,888.44 Typical High $7,585.78 | Professional | None | $3,548.13 | $5,888.44 | $7,585.78 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $5,888.44 | Professional | None | $1,096.48 | $1,905.46 | $5,888.44 |
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 $478.63 Median $478.63 Typical High $5,128.61 | Professional | 52 · Reduced service | $478.63 | $478.63 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $2,041.74 | Professional | 53 · Discontinued | $190.55 | $190.55 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $7,585.78 | Professional | 54 · Surgery only | $707.95 | $707.95 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $1,513.56 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $7,079.46 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | 51 · Multiple procedures | $891.25 | $1,096.48 | $1,584.89 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,778.28 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,445.44 | $1,778.28 | $2,570.40 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $446.68 Typical High $630.96 | Professional | 55 · Aftercare only | $363.08 | $446.68 | $630.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,862.09 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,862.09 | $2,691.53 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 81 · Minimal assistant surgeon | $288.40 | $354.81 | $512.86 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 82 · Assistant surgeon, no resident | $288.40 | $354.81 | $512.86 |
Where Wisconsin sits
The same service costs 6.2 times more in Alaska than in Utah. 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
$3,467
AK $4,266UT $692
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.