How much rates vary
Facilitymedian $8,710 · 10th to 90th $912 to $19,498Professionalmedian $5,495 · 10th to 90th $2,042 to $12,303
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 $2,041.74 Median $2,041.74 Typical High $14,454.40 | Facility | None | $2,041.74 | $2,041.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $15,848.93 | Professional | None | $2,041.74 | $2,041.74 | $15,848.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $14,125.38 Typical High $22,908.68 | Facility | None | $10,000.00 | $14,125.38 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $6,165.95 Typical High $13,489.63 | Professional | None | $1,737.80 | $6,165.95 | $13,489.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $3,890.45 Typical High $7,762.47 | Professional | 62 · Two surgeons | $1,096.48 | $3,890.45 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $1,000.00 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $281.84 | $1,000.00 | $1,995.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $870.96 Typical High $1,737.80 | Professional | AS · PA/NP assist | $245.47 | $870.96 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $6,025.60 | Facility | None | $812.83 | $3,890.45 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $8,511.38 | Professional | None | $2,630.27 | $4,786.30 | $8,511.38 |
DeanCare Setting Facility Modifier None Typical Low $1,778.28 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,778.28 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,235.94 Median $3,981.07 Typical High $5,370.32 | Professional | None | $3,235.94 | $3,981.07 | $5,370.32 |
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 $1,949.84 Median $5,495.41 Typical High $8,912.51 | Professional | None | $1,949.84 | $5,495.41 | $8,912.51 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,162.28 | Facility | None | $2,089.30 | $2,290.87 | $3,162.28 |
Network Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,801.89 Typical High $5,128.61 | Professional | None | $2,238.72 | $3,801.89 | $5,128.61 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,380.38 | $1,949.84 | $3,388.44 |
Quartz Setting Professional Modifier None Typical Low $1,698.24 Median $3,890.45 Typical High $6,918.31 | Professional | None | $1,698.24 | $3,890.45 | $6,918.31 |
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 $2,630.27 Median $2,630.27 Typical High $3,630.78 | Professional | None | $2,630.27 | $2,630.27 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
Security Health Setting Professional Modifier None Typical Low $7,413.10 Median $9,772.37 Typical High $11,220.18 | Professional | None | $7,413.10 | $9,772.37 | $11,220.18 |
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 $1,819.70 Median $5,495.41 Typical High $8,511.38 | Professional | None | $1,819.70 | $5,495.41 | $8,511.38 |
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 $1,023.29 Median $1,023.29 Typical High $7,943.28 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $7,943.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $3,162.28 | Professional | 53 · Discontinued | $407.38 | $407.38 | $3,162.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $12,022.64 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $12,022.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $2,398.83 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $2,398.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $1,584.89 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $11,220.18 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $11,220.18 |
Where Wisconsin sits
The same service costs 5.5 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
$5,754
AK $6,457TX $1,175
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.