How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,479 to $14,454Professionalmedian $3,802 · 10th to 90th $1,349 to $7,943
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 $14,125.38 | Professional | None | $1,548.82 | $1,548.82 | $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 $1,513.56 Median $4,570.88 Typical High $8,317.64 | Professional | None | $1,513.56 | $4,570.88 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $2,884.03 Typical High $5,248.07 | Professional | 62 · Two surgeons | $954.99 | $2,884.03 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $724.44 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $239.88 | $724.44 | $1,348.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $630.96 Typical High $1,174.90 | Professional | AS · PA/NP assist | $218.78 | $630.96 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,981.07 Typical High $7,585.78 | Facility | None | $1,023.29 | $3,981.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $4,265.80 | Professional | None | $1,348.96 | $2,454.71 | $4,265.80 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $5,623.41 Typical High $10,232.93 | Facility | None | $1,318.26 | $5,623.41 | $10,232.93 |
DeanCare Setting Professional Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $3,715.35 | Professional | None | $2,137.96 | $3,235.94 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $6,606.93 Typical High $13,803.84 | Facility | None | $1,148.15 | $6,606.93 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $3,630.78 Typical High $8,128.31 | Professional | None | $1,230.27 | $3,630.78 | $8,128.31 |
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 $1,096.48 Median $1,412.54 Typical High $2,454.71 | Facility | None | $1,096.48 | $1,412.54 | $2,454.71 |
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 $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 $1,659.59 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,659.59 | $1,659.59 | $3,890.45 |
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 $1,096.48 Median $3,311.31 Typical High $5,370.32 | Professional | None | $1,096.48 | $3,311.31 | $5,370.32 |
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 $7,079.46 | Professional | 52 · Reduced service | $776.25 | $776.25 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $2,818.38 | Professional | 53 · Discontinued | $309.03 | $309.03 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $10,715.19 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $10,715.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $2,137.96 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $2,137.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $10,000.00 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $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
$4,365
AK $4,898TX $759
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.