How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,479 to $14,454Professionalmedian $3,715 · 10th to 90th $1,380 to $9,333
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 $1,288.25 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,288.25 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $14,791.08 | Professional | None | $1,288.25 | $1,288.25 | $14,791.08 |
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 $1,380.38 Median $5,248.07 Typical High $9,332.54 | Professional | None | $1,380.38 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $3,311.31 Typical High $5,888.44 | Professional | 62 · Two surgeons | $851.14 | $3,311.31 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $851.14 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $218.78 | $851.14 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $741.31 Typical High $1,318.26 | Professional | AS · PA/NP assist | $190.55 | $741.31 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,897.79 Typical High $10,471.29 | Facility | None | $954.99 | $4,897.79 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $6,309.57 | Professional | None | $2,290.87 | $2,630.27 | $6,309.57 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,548.82 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $4,265.80 | Professional | None | $2,454.71 | $3,019.95 | $4,265.80 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,905.46 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,548.82 | $1,905.46 | $2,691.53 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $478.63 Typical High $691.83 | Professional | 80 · Assistant surgeon | $389.05 | $478.63 | $691.83 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $416.87 Typical High $602.56 | Professional | AS · PA/NP assist | $338.84 | $416.87 | $602.56 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,288.25 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $10,964.78 | Professional | None | $1,548.82 | $4,073.80 | $10,964.78 |
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 $1,737.80 Median $3,467.37 Typical High $4,265.80 | Professional | None | $1,737.80 | $3,467.37 | $4,265.80 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,548.82 Typical High $2,818.38 | Facility | None | $933.25 | $1,548.82 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $1,412.54 Median $3,235.94 Typical High $6,309.57 | Professional | None | $1,412.54 | $3,235.94 | $6,309.57 |
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 $2,630.27 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,630.27 | $2,630.27 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $7,943.28 Typical High $10,232.93 | Professional | None | $4,897.79 | $7,943.28 | $10,232.93 |
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 $1,479.11 Median $2,570.40 Typical High $7,943.28 | Professional | None | $1,479.11 | $2,570.40 | $7,943.28 |
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 $645.65 Median $645.65 Typical High $7,413.10 | Professional | 52 · Reduced service | $645.65 | $645.65 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $2,951.21 | Professional | 53 · Discontinued | $257.04 | $257.04 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $10,964.78 | Professional | 54 · Surgery only | $977.24 | $977.24 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $2,187.76 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $10,232.93 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $10,232.93 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,230.27 Median $1,479.11 Typical High $2,137.96 | Professional | 51 · Multiple procedures | $1,230.27 | $1,479.11 | $2,137.96 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,398.83 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,949.84 | $2,398.83 | $3,467.37 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $602.56 Typical High $870.96 | Professional | 55 · Aftercare only | $489.78 | $602.56 | $870.96 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,511.89 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,511.89 | $3,630.78 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $389.05 Median $478.63 Typical High $691.83 | Professional | 81 · Minimal assistant surgeon | $389.05 | $478.63 | $691.83 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $389.05 Median $478.63 Typical High $691.83 | Professional | 82 · Assistant surgeon, no resident | $389.05 | $478.63 | $691.83 |
Where Wisconsin sits
The same service costs 24.5 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
$4,677
AK $5,754TX $234
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.