How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,230 to $14,454Professionalmedian $2,630 · 10th to 90th $933 to $5,370
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 $1,047.13 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,047.13 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $7,585.78 | Professional | None | $1,047.13 | $1,047.13 | $7,585.78 |
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 $1,047.13 Median $3,235.94 Typical High $5,754.40 | Professional | None | $1,047.13 | $3,235.94 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $4,786.30 Typical High $8,511.38 | Professional | 50 · Both sides | $1,584.89 | $4,786.30 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,995.26 Typical High $3,630.78 | Professional | 62 · Two surgeons | $660.69 | $1,995.26 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $512.86 Typical High $912.01 | Professional | 80 · Assistant surgeon | $165.96 | $512.86 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $446.68 Typical High $794.33 | Professional | AS · PA/NP assist | $147.91 | $446.68 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,311.31 Typical High $7,585.78 | Facility | None | $1,202.26 | $3,311.31 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,023.29 | $1,737.80 | $2,951.21 |
DeanCare Setting Facility Modifier None Typical Low $933.25 Median $5,128.61 Typical High $9,332.54 | Facility | None | $933.25 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $2,187.76 Typical High $2,511.89 | Professional | None | $1,479.11 | $2,187.76 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $15,848.93 | Facility | None | $954.99 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,454.71 Typical High $5,495.41 | Professional | None | $912.01 | $2,454.71 | $5,495.41 |
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 $1,202.26 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,202.26 | $2,089.30 | $2,754.23 |
Prevea360 Setting Facility Modifier None Typical Low $891.25 Median $933.25 Typical High $1,548.82 | Facility | None | $891.25 | $933.25 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $831.76 Median $1,905.46 Typical High $3,548.13 | Professional | None | $831.76 | $1,905.46 | $3,548.13 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $5,011.87 Typical High $8,317.64 | Facility | None | $933.25 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,122.02 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,981.07 Typical High $5,011.87 | Professional | None | $1,905.46 | $3,981.07 | $5,011.87 |
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 $741.31 Median $2,398.83 Typical High $3,715.35 | Professional | None | $741.31 | $2,398.83 | $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 $524.81 Median $524.81 Typical High $3,801.89 | Professional | 52 · Reduced service | $524.81 | $524.81 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $1,513.56 | Professional | 53 · Discontinued | $208.93 | $208.93 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $5,623.41 | Professional | 54 · Surgery only | $794.33 | $794.33 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $1,148.15 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $758.58 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $5,248.07 |
Where Wisconsin sits
The same service costs 7.4 times more in Oklahoma 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· 3rd of 51
$3,311
OK $3,890TX $525
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.