How much rates vary
Facilitymedian $8,128 · 10th to 90th $525 to $18,197Professionalmedian $955 · 10th to 90th $339 to $2,138
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 $346.74 Median $346.74 Typical High $14,454.40 | Facility | None | $346.74 | $346.74 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $4,168.69 | Professional | None | $346.74 | $346.74 | $4,168.69 |
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 $302.00 Median $1,047.13 Typical High $2,187.76 | Professional | None | $302.00 | $1,047.13 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $660.69 Typical High $1,380.38 | Professional | 62 · Two surgeons | $190.55 | $660.69 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $169.82 Typical High $346.74 | Professional | 80 · Assistant surgeon | $48.98 | $169.82 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $144.54 Typical High $323.59 | Professional | AS · PA/NP assist | $42.66 | $144.54 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $758.58 Typical High $1,479.11 | Facility | None | $676.08 | $758.58 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $831.76 Typical High $1,445.44 | Professional | None | $457.09 | $831.76 | $1,445.44 |
DeanCare Setting Facility Modifier None Typical Low $309.03 Median $7,943.28 Typical High $14,454.40 | Facility | None | $309.03 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $954.99 | Professional | None | $562.34 | $691.83 | $954.99 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $2,454.71 Typical High $18,197.01 | Facility | None | $407.38 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $977.24 Typical High $1,584.89 | Professional | None | $346.74 | $977.24 | $1,584.89 |
Network Health Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $2,089.30 | Facility | None | $398.11 | $549.54 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $891.25 | Professional | None | $380.19 | $660.69 | $891.25 |
Prevea360 Setting Facility Modifier None Typical Low $239.88 Median $331.13 Typical High $588.84 | Facility | None | $239.88 | $331.13 | $588.84 |
Quartz Setting Professional Modifier None Typical Low $288.40 Median $616.60 Typical High $1,122.02 | Professional | None | $288.40 | $616.60 | $1,122.02 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,691.53 | Facility | None | $758.58 | $1,023.29 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $630.96 | Professional | None | $457.09 | $457.09 | $630.96 |
Security Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,737.80 | $1,949.84 |
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 $323.59 Median $977.24 Typical High $1,513.56 | Professional | None | $323.59 | $977.24 | $1,513.56 |
5 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 $173.78 Median $173.78 Typical High $2,089.30 | Professional | 52 · Reduced service | $173.78 | $173.78 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $831.76 | Professional | 53 · Discontinued | $69.18 | $69.18 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $3,162.28 | Professional | 54 · Surgery only | $263.03 | $263.03 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $630.96 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $416.87 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $416.87 |
Where Wisconsin sits
The same service costs 3.9 times more in Wisconsin than in New York. 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· 1st of 51
$1,175
WI $1,175NY $302
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.