How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $4,074 · 10th to 90th $1,479 to $8,913
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 $1,479.11 Median $1,479.11 Typical High $14,454.40 | Facility | None | $1,479.11 | $1,479.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $11,748.98 | Professional | None | $1,479.11 | $1,479.11 | $11,748.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $12,589.25 Typical High $19,952.62 | Facility | None | $10,000.00 | $12,589.25 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $4,570.88 Typical High $9,120.11 | Professional | None | $1,288.25 | $4,570.88 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $2,884.03 Typical High $5,754.40 | Professional | 62 · Two surgeons | $812.83 | $2,884.03 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $724.44 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $204.17 | $724.44 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $630.96 Typical High $1,288.25 | Professional | AS · PA/NP assist | $181.97 | $630.96 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,466.84 | Facility | None | $812.83 | $2,884.03 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Professional | None | $1,949.84 | $3,548.13 | $6,165.95 |
DeanCare Setting Facility Modifier None Typical Low $1,318.26 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,318.26 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,951.21 | $3,981.07 |
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 $1,445.44 Median $4,073.80 Typical High $6,606.93 | Professional | None | $1,445.44 | $4,073.80 | $6,606.93 |
Network Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,659.59 | $2,089.30 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $3,715.35 | Professional | None | $1,621.81 | $2,818.38 | $3,715.35 |
Prevea360 Setting Facility Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $2,398.83 | Facility | None | $1,023.29 | $1,412.54 | $2,398.83 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $5,128.61 | Professional | None | $1,258.93 | $2,884.03 | $5,128.61 |
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 $2,630.27 | Professional | None | $1,949.84 | $1,949.84 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $7,244.36 Typical High $8,128.31 | Professional | None | $5,370.32 | $7,244.36 | $8,128.31 |
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 $1,348.96 Median $4,073.80 Typical High $6,309.57 | Professional | None | $1,348.96 | $4,073.80 | $6,309.57 |
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 $741.31 Median $741.31 Typical High $5,888.44 | Professional | 52 · Reduced service | $741.31 | $741.31 | $5,888.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $2,344.23 | Professional | 53 · Discontinued | $295.12 | $295.12 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $8,912.51 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $8,912.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $1,778.28 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $1,778.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $8,317.64 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $8,317.64 |
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
$4,467
AK $4,677TX $851
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.