How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,479 to $14,454Professionalmedian $3,802 · 10th to 90th $1,380 to $7,762
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 $1,548.82 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,548.82 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $10,964.78 | Professional | None | $1,548.82 | $1,548.82 | $10,964.78 |
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 $1,513.56 Median $4,677.35 Typical High $8,317.64 | Professional | None | $1,513.56 | $4,677.35 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $6,918.31 Typical High $12,589.25 | Professional | 50 · Both sides | $2,290.87 | $6,918.31 | $12,589.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $2,951.21 Typical High $5,248.07 | Professional | 62 · Two surgeons | $954.99 | $2,951.21 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $741.31 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $245.47 | $741.31 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $645.65 Typical High $1,174.90 | Professional | AS · PA/NP assist | $213.80 | $645.65 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $4,168.69 Typical High $9,549.93 | Facility | None | $1,202.26 | $4,168.69 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $4,365.16 | Professional | None | $1,513.56 | $2,570.40 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,318.26 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $3,630.78 | Professional | None | $2,137.96 | $3,162.28 | $3,630.78 |
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 $1,348.96 Median $3,548.13 Typical High $7,943.28 | Professional | None | $1,348.96 | $3,548.13 | $7,943.28 |
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 $1,778.28 Median $3,019.95 Typical High $3,981.07 | Professional | None | $1,778.28 | $3,019.95 | $3,981.07 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,290.87 | Facility | None | $933.25 | $1,318.26 | $2,290.87 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $2,754.23 Typical High $5,248.07 | Professional | None | $1,202.26 | $2,754.23 | $5,248.07 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $6,456.54 Typical High $10,471.29 | Facility | None | $933.25 | $6,456.54 | $10,471.29 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,621.81 | $1,621.81 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $5,754.40 Typical High $7,244.36 | Professional | None | $2,884.03 | $5,754.40 | $7,244.36 |
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 $1,071.52 Median $3,467.37 Typical High $5,495.41 | Professional | None | $1,071.52 | $3,467.37 | $5,495.41 |
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 $776.25 Median $776.25 Typical High $5,495.41 | Professional | 52 · Reduced service | $776.25 | $776.25 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $2,187.76 | Professional | 53 · Discontinued | $309.03 | $309.03 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $8,317.64 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $1,659.59 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $7,762.47 |
Where Wisconsin sits
The same service costs 6.6 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
$4,677
AK $4,898TX $741
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.