How much rates vary
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 $1,479.11 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,479.11 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $14,125.38 | Professional | None | $1,479.11 | $1,479.11 | $14,125.38 |
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 $1,479.11 Median $4,570.88 Typical High $8,709.64 | Professional | None | $1,479.11 | $4,570.88 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $6,760.83 Typical High $13,182.57 | Professional | 50 · Both sides | $2,187.76 | $6,760.83 | $13,182.57 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $2,818.38 Typical High $5,495.41 | Professional | 62 · Two surgeons | $933.25 | $2,818.38 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $724.44 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $234.42 | $724.44 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $630.96 Typical High $1,230.27 | Professional | AS · PA/NP assist | $204.17 | $630.96 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $4,073.80 Typical High $7,585.78 | Facility | None | $1,202.26 | $4,073.80 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,584.89 | $2,454.71 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,288.25 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,288.25 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $3,890.45 | Professional | None | $2,089.30 | $3,090.30 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,230.27 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $7,762.47 | Professional | None | $1,318.26 | $3,801.89 | $7,762.47 |
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 $1,698.24 Median $3,548.13 Typical High $4,466.84 | Professional | None | $1,698.24 | $3,548.13 | $4,466.84 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,187.76 | Facility | None | $933.25 | $1,288.25 | $2,187.76 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $5,011.87 | Professional | None | $1,174.90 | $2,691.53 | $5,011.87 |
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 $1,584.89 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,584.89 | $1,584.89 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $6,309.57 Typical High $7,079.46 | Professional | None | $3,548.13 | $6,309.57 | $7,079.46 |
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 $1,122.02 Median $3,388.44 Typical High $6,165.95 | Professional | None | $1,122.02 | $3,388.44 | $6,165.95 |
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 $741.31 Median $741.31 Typical High $7,079.46 | Professional | 52 · Reduced service | $741.31 | $741.31 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $2,818.38 | Professional | 53 · Discontinued | $295.12 | $295.12 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $10,471.29 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $10,471.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $2,137.96 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $2,137.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $9,772.37 |
Where Wisconsin sits
The same service costs 6.8 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· 2nd of 51
$4,467
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.