How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,413 to $14,454Professionalmedian $3,388 · 10th to 90th $1,259 to $8,710
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 $1,202.26 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,202.26 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $12,589.25 | Professional | None | $1,202.26 | $1,202.26 | $12,589.25 |
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 $1,258.93 Median $4,897.79 Typical High $8,709.64 | Professional | None | $1,258.93 | $4,897.79 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $3,090.30 Typical High $5,495.41 | Professional | 62 · Two surgeons | $794.33 | $3,090.30 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $776.25 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $204.17 | $776.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $691.83 Typical High $1,230.27 | Professional | AS · PA/NP assist | $177.83 | $691.83 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,466.84 Typical High $10,471.29 | Facility | None | $954.99 | $4,466.84 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $5,754.40 | Professional | None | $2,137.96 | $2,454.71 | $5,754.40 |
DeanCare Setting Facility Modifier None Typical Low $1,412.54 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,412.54 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $3,981.07 | Professional | None | $2,238.72 | $2,754.23 | $3,981.07 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,737.80 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,412.54 | $1,737.80 | $2,511.89 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $446.68 Typical High $645.65 | Professional | 80 · Assistant surgeon | $363.08 | $446.68 | $645.65 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $389.05 Typical High $562.34 | Professional | AS · PA/NP assist | $316.23 | $389.05 | $562.34 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,202.26 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $9,772.37 | Professional | None | $1,412.54 | $3,801.89 | $9,772.37 |
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 $1,584.89 Median $3,019.95 Typical High $3,890.45 | Professional | None | $1,584.89 | $3,019.95 | $3,890.45 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,630.27 | Facility | None | $933.25 | $1,412.54 | $2,630.27 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $3,019.95 Typical High $5,888.44 | Professional | None | $1,318.26 | $3,019.95 | $5,888.44 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,918.31 Typical High $11,481.54 | Facility | None | $758.58 | $6,918.31 | $11,481.54 |
Quartz Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,454.71 | $2,454.71 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $7,413.10 Typical High $9,549.93 | Professional | None | $4,466.84 | $7,413.10 | $9,549.93 |
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 $1,380.38 Median $2,398.83 Typical High $7,413.10 | Professional | None | $1,380.38 | $2,398.83 | $7,413.10 |
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 $602.56 Median $602.56 Typical High $6,309.57 | Professional | 52 · Reduced service | $602.56 | $602.56 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $2,511.89 | Professional | 53 · Discontinued | $239.88 | $239.88 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $9,549.93 | Professional | 54 · Surgery only | $891.25 | $891.25 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $1,905.46 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $8,912.51 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,122.02 Median $1,380.38 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $1,122.02 | $1,380.38 | $1,995.26 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,238.72 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,819.70 | $2,238.72 | $3,162.28 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | 55 · Aftercare only | $446.68 | $549.54 | $794.33 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,344.23 | $3,388.44 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $363.08 Median $446.68 Typical High $645.65 | Professional | 81 · Minimal assistant surgeon | $363.08 | $446.68 | $645.65 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $363.08 Median $446.68 Typical High $645.65 | Professional | 82 · Assistant surgeon, no resident | $363.08 | $446.68 | $645.65 |
Where Wisconsin sits
The same service costs 11.0 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
$4,365
AK $5,370TX $490
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.