How much rates vary
Facilitymedian $9,550 · 10th to 90th $891 to $21,380Professionalmedian $10,715 · 10th to 90th $3,981 to $21,380
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 $4,168.69 Median $4,168.69 Typical High $14,454.40 | Facility | None | $4,168.69 | $4,168.69 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $41,686.94 | Professional | None | $4,168.69 | $4,168.69 | $41,686.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $17,782.79 Typical High $26,302.68 | Facility | None | $12,022.64 | $17,782.79 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,073.80 Median $12,589.25 Typical High $22,908.68 | Professional | None | $4,073.80 | $12,589.25 | $22,908.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $7,943.28 Typical High $14,125.38 | Professional | 62 · Two surgeons | $2,570.40 | $7,943.28 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $1,995.26 Typical High $3,630.78 | Professional | 80 · Assistant surgeon | $660.69 | $1,995.26 | $3,630.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $1,737.80 Typical High $3,162.28 | Professional | AS · PA/NP assist | $575.44 | $1,737.80 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $8,511.38 Typical High $12,882.50 | Facility | None | $812.83 | $8,511.38 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $6,606.93 Typical High $11,748.98 | Professional | None | $5,248.07 | $6,606.93 | $11,748.98 |
DeanCare Setting Facility Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $14,454.40 | Facility | None | $3,630.78 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $5,888.44 Median $8,709.64 Typical High $11,748.98 | Professional | None | $5,888.44 | $8,709.64 | $11,748.98 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $18,197.01 | Facility | None | $436.52 | $2,818.38 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $3,311.31 Median $10,964.78 Typical High $23,442.29 | Professional | None | $3,311.31 | $10,964.78 | $23,442.29 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $4,897.79 Typical High $6,918.31 | Facility | None | $2,089.30 | $4,897.79 | $6,918.31 |
Network Health Setting Professional Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $11,220.18 | Professional | None | $4,786.30 | $8,317.64 | $11,220.18 |
Prevea360 Setting Facility Modifier None Typical Low $2,238.72 Median $3,801.89 Typical High $7,413.10 | Facility | None | $2,238.72 | $3,801.89 | $7,413.10 |
Quartz Setting Professional Modifier None Typical Low $3,630.78 Median $8,317.64 Typical High $14,125.38 | Professional | None | $3,630.78 | $8,317.64 | $14,125.38 |
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 $5,623.41 Median $5,754.40 Typical High $10,715.19 | Professional | None | $5,623.41 | $5,754.40 | $10,715.19 |
Security Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Security Health Setting Professional Modifier None Typical Low $8,511.38 Median $16,982.44 Typical High $19,498.45 | Professional | None | $8,511.38 | $16,982.44 | $19,498.45 |
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 $3,311.31 Median $9,772.37 Typical High $16,218.10 | Professional | None | $3,311.31 | $9,772.37 | $16,218.10 |
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 $2,089.30 Median $2,089.30 Typical High $20,892.96 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $20,892.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $8,317.64 | Professional | 53 · Discontinued | $831.76 | $831.76 | $8,317.64 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $31,622.78 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $31,622.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $6,309.57 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $6,309.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $416.87 Typical High $4,168.69 | Professional | 56 · Pre-op care only | $416.87 | $416.87 | $4,168.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $29,512.09 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $29,512.09 |
Where Wisconsin sits
The same service costs 10.7 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
$10,471
AK $14,125TX $1,318
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.