How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,905 to $14,454Professionalmedian $5,623 · 10th to 90th $1,995 to $11,220
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 $2,187.76 Median $3,090.30 Typical High $14,454.40 | Facility | None | $2,187.76 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $19,054.61 | Professional | None | $2,187.76 | $2,187.76 | $19,054.61 |
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 $2,187.76 Median $6,606.93 Typical High $12,022.64 | Professional | None | $2,187.76 | $6,606.93 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $4,168.69 Typical High $7,585.78 | Professional | 62 · Two surgeons | $1,380.38 | $4,168.69 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $1,071.52 Typical High $1,905.46 | Professional | 80 · Assistant surgeon | $346.74 | $1,071.52 | $1,905.46 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $933.25 Typical High $1,659.59 | Professional | AS · PA/NP assist | $309.03 | $933.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,248.07 Typical High $8,128.31 | Facility | None | $1,000.00 | $5,248.07 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $6,165.95 | Professional | None | $2,238.72 | $3,715.35 | $6,165.95 |
DeanCare Setting Facility Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,905.46 | $3,311.31 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $3,090.30 Median $4,570.88 Typical High $5,754.40 | Professional | None | $3,090.30 | $4,570.88 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,412.54 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $5,623.41 Typical High $11,748.98 | Professional | None | $1,905.46 | $5,623.41 | $11,748.98 |
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 $2,511.89 Median $4,365.16 Typical High $5,754.40 | Professional | None | $2,511.89 | $4,365.16 | $5,754.40 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $3,388.44 | Facility | None | $575.44 | $1,905.46 | $3,388.44 |
Quartz Setting Professional Modifier None Typical Low $1,778.28 Median $4,073.80 Typical High $7,413.10 | Professional | None | $1,778.28 | $4,073.80 | $7,413.10 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $5,011.87 Typical High $8,317.64 | Facility | None | $724.44 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $5,623.41 | Professional | None | $2,344.23 | $2,344.23 | $5,623.41 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Security Health Setting Professional Modifier None Typical Low $4,365.16 Median $8,709.64 Typical High $10,471.29 | Professional | None | $4,365.16 | $8,709.64 | $10,471.29 |
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 $1,584.89 Median $5,011.87 Typical High $8,128.31 | Professional | None | $1,584.89 | $5,011.87 | $8,128.31 |
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 $1,096.48 Median $1,096.48 Typical High $9,549.93 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $9,549.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $3,890.45 | Professional | 53 · Discontinued | $446.68 | $446.68 | $3,890.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $14,454.40 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $14,454.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $2,884.03 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $2,884.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $1,905.46 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $1,905.46 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $13,489.63 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $13,489.63 |
Where Wisconsin sits
The same service costs 7.1 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
$6,166
AK $7,079TX $1,000
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.