How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $4,467 · 10th to 90th $1,660 to $10,471
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 $1,659.59 Median $1,659.59 Typical High $14,454.40 | Facility | None | $1,659.59 | $1,659.59 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $14,791.08 | Professional | None | $1,659.59 | $1,659.59 | $14,791.08 |
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 $1,412.54 Median $5,011.87 Typical High $10,964.78 | Professional | None | $1,412.54 | $5,011.87 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $3,162.28 Typical High $6,606.93 | Professional | 62 · Two surgeons | $891.25 | $3,162.28 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $812.83 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $229.09 | $812.83 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $691.83 Typical High $1,513.56 | Professional | AS · PA/NP assist | $199.53 | $691.83 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,235.94 Typical High $4,897.79 | Facility | None | $812.83 | $3,235.94 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,890.45 Typical High $6,918.31 | Professional | None | $2,137.96 | $3,890.45 | $6,918.31 |
DeanCare Setting Facility Modifier None Typical Low $1,445.44 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,445.44 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,630.27 | $3,311.31 | $4,365.16 |
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 $1,584.89 Median $4,466.84 Typical High $7,244.36 | Professional | None | $1,584.89 | $4,466.84 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,691.53 | Facility | None | $1,862.09 | $2,089.30 | $2,691.53 |
Network Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,090.30 Typical High $4,168.69 | Professional | None | $1,819.70 | $3,090.30 | $4,168.69 |
Prevea360 Setting Facility Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $2,754.23 | Facility | None | $1,122.02 | $1,584.89 | $2,754.23 |
Quartz Setting Professional Modifier None Typical Low $1,412.54 Median $3,235.94 Typical High $5,623.41 | Professional | None | $1,412.54 | $3,235.94 | $5,623.41 |
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 $2,137.96 Median $2,137.96 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,137.96 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Security Health Setting Professional Modifier None Typical Low $6,025.60 Median $7,943.28 Typical High $9,120.11 | Professional | None | $6,025.60 | $7,943.28 | $9,120.11 |
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 $1,479.11 Median $4,466.84 Typical High $6,918.31 | Professional | None | $1,479.11 | $4,466.84 | $6,918.31 |
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 $831.76 Median $831.76 Typical High $7,413.10 | Professional | 52 · Reduced service | $831.76 | $831.76 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $2,951.21 | Professional | 53 · Discontinued | $331.13 | $331.13 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $11,220.18 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $11,220.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $2,238.72 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $2,238.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $10,471.29 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $10,471.29 |
Where Wisconsin sits
The same service costs 5.0 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
$4,786
AK $5,248TX $1,047
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.