How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,380 to $14,454Professionalmedian $3,311 · 10th to 90th $1,230 to $8,511
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 $1,174.90 Median $1,905.46 Typical High $14,454.40 | Facility | None | $1,174.90 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $17,782.79 | Professional | None | $1,174.90 | $1,174.90 | $17,782.79 |
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 $1,230.27 Median $4,786.30 Typical High $8,511.38 | Professional | None | $1,230.27 | $4,786.30 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $3,019.95 Typical High $5,370.32 | Professional | 62 · Two surgeons | $776.25 | $3,019.95 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $776.25 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $199.53 | $776.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $676.08 Typical High $1,202.26 | Professional | AS · PA/NP assist | $173.78 | $676.08 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,365.16 Typical High $10,471.29 | Facility | None | $707.95 | $4,365.16 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $5,623.41 | Professional | None | $2,041.74 | $2,398.83 | $5,623.41 |
DeanCare Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $5,128.61 | Facility | None | $1,174.90 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,691.53 | $3,715.35 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,698.24 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,380.38 | $1,698.24 | $2,344.23 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $436.52 Typical High $602.56 | Professional | 80 · Assistant surgeon | $354.81 | $436.52 | $602.56 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $380.19 Typical High $524.81 | Professional | AS · PA/NP assist | $309.03 | $380.19 | $524.81 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,148.15 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $3,715.35 Typical High $10,000.00 | Professional | None | $1,380.38 | $3,715.35 | $10,000.00 |
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 $2,511.89 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,511.89 | $3,715.35 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,380.38 Typical High $2,570.40 | Facility | None | $933.25 | $1,380.38 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $1,288.25 Median $2,951.21 Typical High $5,754.40 | Professional | None | $1,288.25 | $2,951.21 | $5,754.40 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $6,918.31 Typical High $11,481.54 | Facility | None | $537.03 | $6,918.31 | $11,481.54 |
Quartz Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,398.83 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Security Health Setting Professional Modifier None Typical Low $4,365.16 Median $7,079.46 Typical High $9,332.54 | Professional | None | $4,365.16 | $7,079.46 | $9,332.54 |
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 $1,318.26 Median $2,344.23 Typical High $7,244.36 | Professional | None | $1,318.26 | $2,344.23 | $7,244.36 |
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 $588.84 Median $588.84 Typical High $8,912.51 | Professional | 52 · Reduced service | $588.84 | $588.84 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $3,548.13 | Professional | 53 · Discontinued | $234.42 | $234.42 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $13,489.63 | Professional | 54 · Surgery only | $870.96 | $870.96 | $13,489.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $2,691.53 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $12,589.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $12,589.25 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $1,096.48 Median $1,348.96 Typical High $1,862.09 | Professional | 51 · Multiple procedures | $1,096.48 | $1,348.96 | $1,862.09 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,187.76 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,778.28 | $2,187.76 | $3,019.95 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $549.54 Typical High $741.31 | Professional | 55 · Aftercare only | $446.68 | $549.54 | $741.31 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,290.87 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,290.87 | $3,162.28 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $354.81 Median $436.52 Typical High $602.56 | Professional | 81 · Minimal assistant surgeon | $354.81 | $436.52 | $602.56 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $354.81 Median $436.52 Typical High $602.56 | Professional | 82 · Assistant surgeon, no resident | $354.81 | $436.52 | $602.56 |
Where Wisconsin sits
The same service costs 7.9 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
$4,074
AK $5,248TX $661
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.