How much rates vary
Facilitymedian $8,511 · 10th to 90th $891 to $21,380Professionalmedian $5,129 · 10th to 90th $1,905 to $11,482
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 $1,905.46 Median $1,905.46 Typical High $14,454.40 | Facility | None | $1,905.46 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $15,135.61 | Professional | None | $1,905.46 | $1,905.46 | $15,135.61 |
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 $1,659.59 Median $5,754.40 Typical High $12,589.25 | Professional | None | $1,659.59 | $5,754.40 | $12,589.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $3,630.78 Typical High $7,413.10 | Professional | 62 · Two surgeons | $1,047.13 | $3,630.78 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $933.25 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $263.03 | $933.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $794.33 Typical High $1,778.28 | Professional | AS · PA/NP assist | $229.09 | $794.33 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,715.35 Typical High $5,623.41 | Facility | None | $812.83 | $3,715.35 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $4,466.84 Typical High $7,943.28 | Professional | None | $2,454.71 | $4,466.84 | $7,943.28 |
DeanCare Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $5,011.87 | Professional | None | $3,090.30 | $3,801.89 | $5,011.87 |
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 $1,862.09 Median $5,248.07 Typical High $8,317.64 | Professional | None | $1,862.09 | $5,248.07 | $8,317.64 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $3,019.95 | Facility | None | $2,089.30 | $2,137.96 | $3,019.95 |
Network Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,089.30 | $3,630.78 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,318.26 | $1,819.70 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,456.54 | Professional | None | $1,621.81 | $3,715.35 | $6,456.54 |
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 $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Security Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Security Health Setting Professional Modifier None Typical Low $6,918.31 Median $9,332.54 Typical High $10,471.29 | Professional | None | $6,918.31 | $9,332.54 | $10,471.29 |
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 $1,698.24 Median $5,248.07 Typical High $8,128.31 | Professional | None | $1,698.24 | $5,248.07 | $8,128.31 |
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 $954.99 Median $954.99 Typical High $7,585.78 | Professional | 52 · Reduced service | $954.99 | $954.99 | $7,585.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $3,019.95 | Professional | 53 · Discontinued | $380.19 | $380.19 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $11,220.18 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $11,220.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $2,238.72 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $2,238.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $1,513.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $10,471.29 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $10,471.29 |
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
$5,495
AK $6,026TX $1,072
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.