How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,349 to $15,136Professionalmedian $3,467 · 10th to 90th $1,259 to $8,318
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 $1,258.93 Median $1,258.93 Typical High $14,454.40 | Facility | None | $1,258.93 | $1,258.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $11,748.98 | Professional | None | $1,258.93 | $1,258.93 | $11,748.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $3,981.07 Typical High $8,317.64 | Professional | None | $1,096.48 | $3,981.07 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $5,754.40 Typical High $12,302.69 | Professional | 50 · Both sides | $1,621.81 | $5,754.40 | $12,302.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $2,454.71 Typical High $5,248.07 | Professional | 62 · Two surgeons | $691.83 | $2,454.71 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $630.96 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $173.78 | $630.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $549.54 Typical High $1,148.15 | Professional | AS · PA/NP assist | $151.36 | $549.54 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,235.94 Typical High $7,943.28 | Facility | None | $1,023.29 | $3,235.94 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,951.21 Typical High $5,248.07 | Professional | None | $1,621.81 | $2,951.21 | $5,248.07 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,096.48 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,454.71 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $7,585.78 Typical High $15,135.61 | Facility | None | $1,202.26 | $7,585.78 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $3,630.78 Typical High $5,623.41 | Professional | None | $1,348.96 | $3,630.78 | $5,623.41 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,380.38 | $2,630.27 | $3,630.78 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,137.96 | Facility | None | $851.14 | $1,202.26 | $2,137.96 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,023.29 | $2,344.23 | $4,365.16 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $5,370.32 Typical High $8,709.64 | Facility | None | $812.83 | $5,370.32 | $8,709.64 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,621.81 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Security Health Setting Professional Modifier None Typical Low $5,248.07 Median $6,456.54 Typical High $6,918.31 | Professional | None | $5,248.07 | $6,456.54 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $3,467.37 Typical High $5,370.32 | Professional | None | $1,148.15 | $3,467.37 | $5,370.32 |
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 $630.96 Median $630.96 Typical High $5,754.40 | Professional | 52 · Reduced service | $630.96 | $630.96 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $2,344.23 | Professional | 53 · Discontinued | $251.19 | $251.19 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $8,709.64 | Professional | 54 · Surgery only | $933.25 | $933.25 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $1,737.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $8,128.31 |
Where Wisconsin sits
The same service costs 5.1 times more in Wisconsin 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· 1st of 51
$4,677
WI $4,677TX $912
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.