How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $4,786 · 10th to 90th $1,778 to $10,715
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 $1,778.28 Median $1,778.28 Typical High $14,454.40 | Facility | None | $1,778.28 | $1,778.28 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $14,125.38 | Professional | None | $1,778.28 | $1,778.28 | $14,125.38 |
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 $1,548.82 Median $5,495.41 Typical High $11,748.98 | Professional | None | $1,548.82 | $5,495.41 | $11,748.98 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $3,388.44 Typical High $6,918.31 | Professional | 62 · Two surgeons | $977.24 | $3,388.44 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $870.96 Typical High $1,737.80 | Professional | 80 · Assistant surgeon | $245.47 | $870.96 | $1,737.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $758.58 Typical High $1,513.56 | Professional | AS · PA/NP assist | $213.80 | $758.58 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $5,248.07 | Facility | None | $812.83 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $4,168.69 Typical High $7,413.10 | Professional | None | $2,344.23 | $4,168.69 | $7,413.10 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,548.82 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,884.03 | $3,548.13 | $4,677.35 |
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 $1,737.80 Median $4,897.79 Typical High $7,762.47 | Professional | None | $1,737.80 | $4,897.79 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,995.26 | $2,089.30 | $3,019.95 |
Network Health Setting Professional Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $4,466.84 | Professional | None | $1,949.84 | $3,388.44 | $4,466.84 |
Prevea360 Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,951.21 | Facility | None | $1,230.27 | $1,698.24 | $2,951.21 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $6,165.95 | Professional | None | $1,513.56 | $3,467.37 | $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 $2,344.23 Median $2,344.23 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,344.23 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Security Health Setting Professional Modifier None Typical Low $6,456.54 Median $8,709.64 Typical High $9,772.37 | Professional | None | $6,456.54 | $8,709.64 | $9,772.37 |
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 $1,584.89 Median $4,897.79 Typical High $7,585.78 | Professional | None | $1,584.89 | $4,897.79 | $7,585.78 |
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 $891.25 Median $891.25 Typical High $7,079.46 | Professional | 52 · Reduced service | $891.25 | $891.25 | $7,079.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $2,818.38 | Professional | 53 · Discontinued | $354.81 | $354.81 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $10,715.19 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $10,715.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $2,137.96 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $2,137.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $10,000.00 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $10,000.00 |
Where Wisconsin sits
The same service costs 5.6 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
$5,248
AK $5,623TX $1,000
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.