How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $4,467 · 10th to 90th $1,660 to $9,333
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $16,595.87 | Professional | None | $1,819.70 | $1,819.70 | $16,595.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $18,620.87 | Facility | None | $6,309.57 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $5,495.41 Typical High $9,772.37 | Professional | None | $1,778.28 | $5,495.41 | $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 $1,584.89 | Professional | 80 · Assistant surgeon | $281.84 | $870.96 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $758.58 Typical High $1,380.38 | Professional | AS · PA/NP assist | $251.19 | $758.58 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,715.35 Typical High $5,623.41 | Facility | None | $812.83 | $3,715.35 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $5,370.32 | Professional | None | $1,949.84 | $2,951.21 | $5,370.32 |
DeanCare Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,801.89 Typical High $4,570.88 | Professional | None | $2,511.89 | $3,801.89 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $4,265.80 Typical High $9,120.11 | Professional | None | $1,584.89 | $4,265.80 | $9,120.11 |
Network Health Setting Facility Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,949.84 | $2,089.30 | $3,019.95 |
Network Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,089.30 | $3,548.13 | $4,677.35 |
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 $1,348.96 Median $3,090.30 Typical High $6,165.95 | Professional | None | $1,348.96 | $3,090.30 | $6,165.95 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $4,365.16 | Professional | None | $1,949.84 | $1,949.84 | $4,365.16 |
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 $7,079.46 Typical High $8,511.38 | Professional | None | $3,388.44 | $7,079.46 | $8,511.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $6,606.93 | Professional | None | $1,288.25 | $4,073.80 | $6,606.93 |
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 $912.01 Median $912.01 Typical High $8,317.64 | Professional | 52 · Reduced service | $912.01 | $912.01 | $8,317.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $3,311.31 | Professional | 53 · Discontinued | $363.08 | $363.08 | $3,311.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $12,589.25 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $12,589.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $2,511.89 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $2,511.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $1,659.59 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $1,659.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $11,748.98 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $11,748.98 |
Where Wisconsin sits
The same service costs 7.8 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
$4,571
AK $5,754TX $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.