How much rates vary
Facilitymedian $7,943 · 10th to 90th $631 to $18,197Professionalmedian $1,096 · 10th to 90th $407 to $2,344
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 $407.38 Median $407.38 Typical High $14,454.40 | Facility | None | $407.38 | $407.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $8,709.64 | Professional | None | $407.38 | $407.38 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $1,288.25 Typical High $2,454.71 | Professional | None | $416.87 | $1,288.25 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $794.33 Typical High $1,548.82 | Professional | 62 · Two surgeons | $263.03 | $794.33 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $204.17 Typical High $398.11 | Professional | 80 · Assistant surgeon | $66.07 | $204.17 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $177.83 Typical High $346.74 | Professional | AS · PA/NP assist | $58.88 | $177.83 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,949.84 | Facility | None | $812.83 | $1,096.48 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,318.26 | Professional | None | $575.44 | $691.83 | $1,318.26 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $7,943.28 Typical High $14,791.08 | Facility | None | $416.87 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $2,454.71 Typical High $18,197.01 | Facility | None | $416.87 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $1,096.48 Typical High $1,949.84 | Professional | None | $371.54 | $1,096.48 | $1,949.84 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,096.48 | $1,122.02 | $1,122.02 |
Prevea360 Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $724.44 | Facility | None | $346.74 | $416.87 | $724.44 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $724.44 Typical High $1,096.48 | Professional | None | $346.74 | $724.44 | $1,096.48 |
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 $616.60 Median $616.60 Typical High $1,071.52 | Professional | None | $616.60 | $616.60 | $1,071.52 |
Security Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,949.84 | $2,238.72 |
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 $363.08 Median $1,047.13 Typical High $1,584.89 | Professional | None | $363.08 | $1,047.13 | $1,584.89 |
3 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 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $6,606.93 | Professional | 54 · Surgery only | $309.03 | $309.03 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $1,318.26 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $870.96 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $870.96 |
Where Wisconsin sits
The same service costs 9.8 times more in Indiana than in Hawaii. 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· 5th of 51
$1,318
IN $2,344HI $240
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.