How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,349 to $15,136Professionalmedian $3,311 · 10th to 90th $1,230 to $6,918
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 $1,230.27 Median $1,230.27 Typical High $14,454.40 | Facility | None | $1,230.27 | $1,230.27 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $10,000.00 | Professional | None | $1,230.27 | $1,230.27 | $10,000.00 |
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 $1,122.02 Median $3,715.35 Typical High $7,943.28 | Professional | None | $1,122.02 | $3,715.35 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $5,495.41 Typical High $12,022.64 | Professional | 50 · Both sides | $1,584.89 | $5,495.41 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $2,344.23 Typical High $5,011.87 | Professional | 62 · Two surgeons | $660.69 | $2,344.23 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $602.56 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $169.82 | $602.56 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $524.81 Typical High $1,122.02 | Professional | AS · PA/NP assist | $147.91 | $524.81 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,090.30 Typical High $7,943.28 | Facility | None | $1,023.29 | $3,090.30 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $5,011.87 | Professional | None | $1,584.89 | $2,884.03 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $1,071.52 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,071.52 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,949.84 | $2,398.83 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $7,585.78 Typical High $15,135.61 | Facility | None | $1,148.15 | $7,585.78 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $5,370.32 | Professional | None | $1,230.27 | $3,388.44 | $5,370.32 |
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 $1,318.26 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,318.26 | $2,290.87 | $3,235.94 |
Prevea360 Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,041.74 | Facility | None | $831.76 | $1,148.15 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,000.00 | $2,290.87 | $4,168.69 |
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 $1,584.89 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,584.89 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $6,760.83 | Professional | None | $4,677.35 | $5,888.44 | $6,760.83 |
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 $1,096.48 Median $3,388.44 Typical High $5,248.07 | Professional | None | $1,096.48 | $3,388.44 | $5,248.07 |
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 $602.56 Median $602.56 Typical High $5,011.87 | Professional | 52 · Reduced service | $602.56 | $602.56 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $1,995.26 | Professional | 53 · Discontinued | $245.47 | $245.47 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $7,585.78 | Professional | 54 · Surgery only | $912.01 | $912.01 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $1,513.56 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $7,079.46 |
Where Wisconsin sits
The same service costs 5.0 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
$4,365
WI $4,365TX $871
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.