How much rates vary
Facilitymedian $6,607 · 10th to 90th $891 to $16,982Professionalmedian $4,266 · 10th to 90th $1,585 to $8,913
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 $1,584.89 Median $1,584.89 Typical High $14,454.40 | Facility | None | $1,584.89 | $1,584.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $12,302.69 | Professional | None | $1,584.89 | $1,584.89 | $12,302.69 |
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 $1,380.38 Median $4,786.30 Typical High $10,471.29 | Professional | None | $1,380.38 | $4,786.30 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $7,244.36 Typical High $14,125.38 | Professional | 50 · Both sides | $2,041.74 | $7,244.36 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $3,019.95 Typical High $6,025.60 | Professional | 62 · Two surgeons | $870.96 | $3,019.95 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $776.25 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $218.78 | $776.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $676.08 Typical High $1,318.26 | Professional | AS · PA/NP assist | $190.55 | $676.08 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,090.30 Typical High $4,677.35 | Facility | None | $812.83 | $3,090.30 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,715.35 Typical High $6,606.93 | Professional | None | $2,041.74 | $3,715.35 | $6,606.93 |
DeanCare Setting Facility Modifier None Typical Low $1,380.38 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,380.38 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,162.28 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $6,918.31 | Professional | None | $1,513.56 | $4,265.80 | $6,918.31 |
Network Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,511.89 | Facility | None | $1,778.28 | $2,089.30 | $2,511.89 |
Network Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $3,981.07 | Professional | None | $1,737.80 | $2,951.21 | $3,981.07 |
Prevea360 Setting Facility Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,630.27 | Facility | None | $1,071.52 | $1,513.56 | $2,630.27 |
Quartz Setting Professional Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,370.32 | Professional | None | $1,348.96 | $3,090.30 | $5,370.32 |
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 $2,041.74 Median $2,041.74 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,041.74 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Security Health Setting Professional Modifier None Typical Low $5,754.40 Median $7,585.78 Typical High $8,709.64 | Professional | None | $5,754.40 | $7,585.78 | $8,709.64 |
The Alliance Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $8,912.51 | Professional | None | $7,244.36 | $7,244.36 | $8,912.51 |
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 $1,412.54 Median $4,265.80 Typical High $6,606.93 | Professional | None | $1,412.54 | $4,265.80 | $6,606.93 |
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 $794.33 Median $794.33 Typical High $6,165.95 | Professional | 52 · Reduced service | $794.33 | $794.33 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $2,511.89 | Professional | 53 · Discontinued | $316.23 | $316.23 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $9,332.54 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $1,862.09 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $8,709.64 |
Where Wisconsin sits
The same service costs 4.8 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
$4,571
AK $5,012TX $1,047
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.