How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,072 to $7,943Professionalmedian $2,512 · 10th to 90th $871 to $4,074
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 $776.25 Median $6,456.54 Typical High $14,454.40 | Facility | None | $776.25 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $10,000.00 | Professional | None | $776.25 | $776.25 | $10,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $4,168.69 | Professional | None | $1,047.13 | $2,754.23 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,737.80 Typical High $2,630.27 | Professional | 62 · Two surgeons | $660.69 | $1,737.80 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $436.52 Typical High $676.08 | Professional | 80 · Assistant surgeon | $169.82 | $436.52 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $389.05 Typical High $588.84 | Professional | AS · PA/NP assist | $147.91 | $389.05 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,398.83 Typical High $3,235.94 | Facility | None | $954.99 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $5,011.87 | Professional | None | $977.24 | $1,621.81 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $1,000.00 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,000.00 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,621.81 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,630.78 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,454.71 Typical High $6,760.83 | Professional | None | $954.99 | $2,454.71 | $6,760.83 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,862.09 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,230.27 | $2,041.74 | $2,630.27 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,819.70 | Facility | None | $812.83 | $1,000.00 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,890.45 | Professional | None | $933.25 | $1,995.26 | $3,890.45 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $3,235.94 | Facility | None | $758.58 | $2,041.74 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $2,187.76 | Professional | None | $891.25 | $1,023.29 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $1,621.81 Median $3,890.45 Typical High $4,570.88 | Professional | None | $1,621.81 | $3,890.45 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,819.70 Typical High $3,715.35 | Professional | None | $831.76 | $1,819.70 | $3,715.35 |
6 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 $389.05 Median $389.05 Typical High $5,011.87 | Professional | 52 · Reduced service | $389.05 | $389.05 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $1,995.26 | Professional | 53 · Discontinued | $154.88 | $154.88 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $7,585.78 | Professional | 54 · Surgery only | $575.44 | $575.44 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $1,513.56 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $7,079.46 |
Where Wisconsin sits
The same service costs 7.6 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
$2,630
AK $3,715TX $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.