How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $6,607 · 10th to 90th $2,455 to $15,488
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 $2,454.71 Median $2,454.71 Typical High $14,454.40 | Facility | None | $2,454.71 | $2,454.71 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $22,908.68 | Professional | None | $2,454.71 | $2,454.71 | $22,908.68 |
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 $2,137.96 Median $7,413.10 Typical High $16,218.10 | Professional | None | $2,137.96 | $7,413.10 | $16,218.10 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $4,677.35 Typical High $10,000.00 | Professional | 62 · Two surgeons | $1,318.26 | $4,677.35 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $1,202.26 Typical High $2,511.89 | Professional | 80 · Assistant surgeon | $338.84 | $1,202.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $1,047.13 Typical High $2,187.76 | Professional | AS · PA/NP assist | $295.12 | $1,047.13 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $7,244.36 | Facility | None | $812.83 | $4,786.30 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $10,232.93 | Professional | None | $3,162.28 | $5,754.40 | $10,232.93 |
DeanCare Setting Facility Modifier None Typical Low $2,137.96 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,137.96 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,890.45 Median $4,897.79 Typical High $6,456.54 | Professional | None | $3,890.45 | $4,897.79 | $6,456.54 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,398.83 Median $6,606.93 Typical High $10,715.19 | Professional | None | $2,398.83 | $6,606.93 | $10,715.19 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,981.07 | Facility | None | $2,089.30 | $2,754.23 | $3,981.07 |
Network Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,570.88 Typical High $6,309.57 | Professional | None | $2,691.53 | $4,570.88 | $6,309.57 |
Prevea360 Setting Facility Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,890.45 | Facility | None | $1,659.59 | $2,344.23 | $3,890.45 |
Quartz Setting Professional Modifier None Typical Low $2,041.74 Median $4,677.35 Typical High $8,317.64 | Professional | None | $2,041.74 | $4,677.35 | $8,317.64 |
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 $3,162.28 Median $3,162.28 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,162.28 | $4,365.16 |
Security Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | None | $9,549.93 | $9,549.93 | $9,549.93 |
Security Health Setting Professional Modifier None Typical Low $9,120.11 Median $11,748.98 Typical High $13,489.63 | Professional | None | $9,120.11 | $11,748.98 | $13,489.63 |
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 $2,187.76 Median $6,760.83 Typical High $10,471.29 | Professional | None | $2,187.76 | $6,760.83 | $10,471.29 |
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 $1,230.27 Median $1,230.27 Typical High $11,481.54 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $11,481.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $4,570.88 | Professional | 53 · Discontinued | $489.78 | $489.78 | $4,570.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $17,378.01 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $17,378.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $3,467.37 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $3,467.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $2,290.87 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $2,290.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $16,218.10 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $16,218.10 |
Where Wisconsin sits
The same service costs 6.0 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
$6,918
AK $7,762TX $1,288
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.