How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,738 to $13,804Professionalmedian $4,467 · 10th to 90th $1,698 to $9,120
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 $1,778.28 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,778.28 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $14,454.40 | Professional | None | $1,778.28 | $1,778.28 | $14,454.40 |
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 $1,778.28 Median $5,370.32 Typical High $9,772.37 | Professional | None | $1,778.28 | $5,370.32 | $9,772.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $3,388.44 Typical High $6,165.95 | Professional | 62 · Two surgeons | $1,122.02 | $3,388.44 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $870.96 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $281.84 | $870.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $758.58 Typical High $1,348.96 | Professional | AS · PA/NP assist | $251.19 | $758.58 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $7,585.78 | Facility | None | $1,023.29 | $4,365.16 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $5,623.41 | Professional | None | $1,862.09 | $2,951.21 | $5,623.41 |
DeanCare Setting Facility Modifier None Typical Low $1,659.59 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,659.59 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,715.35 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $4,570.88 Typical High $12,589.25 | Facility | None | $1,230.27 | $4,570.88 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $4,365.16 Typical High $9,549.93 | Professional | None | $1,621.81 | $4,365.16 | $9,549.93 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,041.74 | $3,630.78 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,884.03 | Facility | None | $1,288.25 | $1,737.80 | $2,884.03 |
Quartz Setting Professional Modifier None Typical Low $1,412.54 Median $3,235.94 Typical High $6,025.60 | Professional | None | $1,412.54 | $3,235.94 | $6,025.60 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $5,011.87 Typical High $8,317.64 | Facility | None | $812.83 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $4,570.88 | Professional | None | $1,905.46 | $1,905.46 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Security Health Setting Professional Modifier None Typical Low $3,388.44 Median $7,585.78 Typical High $8,511.38 | Professional | None | $3,388.44 | $7,585.78 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $7,079.46 | Professional | None | $1,318.26 | $4,168.69 | $7,079.46 |
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 $891.25 Median $891.25 Typical High $7,244.36 | Professional | 52 · Reduced service | $891.25 | $891.25 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $2,884.03 | Professional | 53 · Discontinued | $363.08 | $363.08 | $2,884.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $10,715.19 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $10,715.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $2,137.96 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $2,137.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $1,445.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $10,000.00 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $10,000.00 |
Where Wisconsin sits
The same service costs 6.5 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
$5,129
AK $5,754TX $891
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.