How much rates vary
Facilitymedian $9,550 · 10th to 90th $708 to $22,387Professionalmedian $1,230 · 10th to 90th $631 to $4,677
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 $630.96 Median $630.96 Typical High $14,454.40 | Facility | None | $630.96 | $630.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $3,388.44 | Professional | None | $630.96 | $630.96 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $18,620.87 Typical High $25,703.96 | Facility | None | $13,182.57 | $18,620.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,862.09 Typical High $5,011.87 | Professional | None | $676.08 | $1,862.09 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $302.00 Typical High $794.33 | Professional | 80 · Assistant surgeon | $109.65 | $302.00 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $263.03 Typical High $691.83 | Professional | AS · PA/NP assist | $95.50 | $263.03 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,905.46 Typical High $3,162.28 | Facility | None | $812.83 | $1,905.46 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $2,511.89 | Professional | None | $660.69 | $660.69 | $2,511.89 |
DeanCare Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,445.44 | Facility | None | $645.65 | $794.33 | $1,445.44 |
DeanCare Setting Professional Modifier None Typical Low $831.76 Median $1,412.54 Typical High $1,698.24 | Professional | None | $831.76 | $1,412.54 | $1,698.24 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $223.87 Typical High $275.42 | Professional | 80 · Assistant surgeon | $131.83 | $223.87 | $275.42 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $199.53 Typical High $239.88 | Professional | AS · PA/NP assist | $114.82 | $199.53 | $239.88 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $2,454.71 Typical High $18,197.01 | Facility | None | $501.19 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $2,238.72 Typical High $4,677.35 | Professional | None | $794.33 | $2,238.72 | $4,677.35 |
Network Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Network Health Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $1,905.46 | Professional | None | $870.96 | $1,479.11 | $1,905.46 |
Prevea360 Setting Facility Modifier None Typical Low $645.65 Median $794.33 Typical High $1,445.44 | Facility | None | $645.65 | $794.33 | $1,445.44 |
Prevea360 Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Quartz Setting Professional Modifier None Typical Low $707.95 Median $1,659.59 Typical High $3,090.30 | Professional | None | $707.95 | $1,659.59 | $3,090.30 |
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 $660.69 Median $660.69 Typical High $1,071.52 | Professional | None | $660.69 | $660.69 | $1,071.52 |
Security Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $5,248.07 | Professional | None | $1,445.44 | $2,137.96 | $5,248.07 |
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 $707.95 Median $1,230.27 Typical High $3,162.28 | Professional | None | $707.95 | $1,230.27 | $3,162.28 |
11 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 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $2,570.40 | Professional | 54 · Surgery only | $467.74 | $467.74 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $512.86 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $338.84 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $2,398.83 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $407.38 Median $707.95 Typical High $851.14 | Professional | 51 · Multiple procedures | $407.38 | $707.95 | $851.14 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,122.02 Typical High $1,348.96 | Professional | 54 · Surgery only | $660.69 | $1,122.02 | $1,348.96 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $281.84 Typical High $338.84 | Professional | 55 · Aftercare only | $165.96 | $281.84 | $338.84 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $891.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $512.86 | $891.25 | $1,071.52 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,174.90 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $691.83 | $1,174.90 | $1,445.44 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $131.83 Median $223.87 Typical High $275.42 | Professional | 81 · Minimal assistant surgeon | $131.83 | $223.87 | $275.42 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $131.83 Median $223.87 Typical High $275.42 | Professional | 82 · Assistant surgeon, no resident | $131.83 | $223.87 | $275.42 |
Where Wisconsin sits
The same service costs 3.8 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· 4th of 51
$1,349
AK $1,862TX $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.