How much rates vary
Facilitymedian $5,129 · 10th to 90th $603 to $15,136Professionalmedian $1,349 · 10th to 90th $479 to $3,467
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 $478.63 Median $478.63 Typical High $14,454.40 | Facility | None | $478.63 | $478.63 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $6,309.57 | Professional | None | $478.63 | $478.63 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,317.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $1,584.89 Typical High $4,265.80 | Professional | None | $416.87 | $1,584.89 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $2,290.87 Typical High $6,309.57 | Professional | 50 · Both sides | $616.60 | $2,290.87 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $1,000.00 Typical High $2,691.53 | Professional | 62 · Two surgeons | $263.03 | $1,000.00 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $251.19 Typical High $676.08 | Professional | 80 · Assistant surgeon | $66.07 | $251.19 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $218.78 Typical High $588.84 | Professional | AS · PA/NP assist | $57.54 | $218.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,698.24 | Facility | None | $812.83 | $1,047.13 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $1,995.26 | Professional | None | $616.60 | $1,122.02 | $1,995.26 |
DeanCare Setting Facility Modifier None Typical Low $416.87 Median $7,943.28 Typical High $14,454.40 | Facility | None | $416.87 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,348.96 | Professional | None | $758.58 | $933.25 | $1,348.96 |
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 $602.56 Median $1,445.44 Typical High $2,187.76 | Professional | None | $602.56 | $1,445.44 | $2,187.76 |
Network Health Setting Facility Modifier None Typical Low $537.03 Median $1,202.26 Typical High $2,089.30 | Facility | None | $537.03 | $1,202.26 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $524.81 Median $1,258.93 Typical High $1,698.24 | Professional | None | $524.81 | $1,258.93 | $1,698.24 |
Prevea360 Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $870.96 | Facility | None | $323.59 | $457.09 | $870.96 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $831.76 Typical High $1,548.82 | Professional | None | $398.11 | $831.76 | $1,548.82 |
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 $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Security Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,511.89 | $3,311.31 |
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 $457.09 Median $1,412.54 Typical High $2,137.96 | Professional | None | $457.09 | $1,412.54 | $2,137.96 |
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 $239.88 Median $239.88 Typical High $3,162.28 | Professional | 52 · Reduced service | $239.88 | $239.88 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $1,258.93 | Professional | 53 · Discontinued | $95.50 | $95.50 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $4,677.35 | Professional | 54 · Surgery only | $354.81 | $354.81 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $933.25 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $630.96 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $630.96 |
Where Wisconsin sits
The same service costs 3.7 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
$1,622
WI $1,622NY $437
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.