How much rates vary
Facilitymedian $6,607 · 10th to 90th $891 to $16,982Professionalmedian $4,898 · 10th to 90th $1,820 to $10,233
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $17,782.79 | Professional | None | $1,819.70 | $1,819.70 | $17,782.79 |
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 $1,548.82 Median $5,495.41 Typical High $11,748.98 | Professional | None | $1,548.82 | $5,495.41 | $11,748.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $8,317.64 Typical High $16,595.87 | Professional | 50 · Both sides | $2,344.23 | $8,317.64 | $16,595.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $3,467.37 Typical High $6,918.31 | Professional | 62 · Two surgeons | $977.24 | $3,467.37 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $870.96 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $251.19 | $870.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $776.25 Typical High $1,548.82 | Professional | AS · PA/NP assist | $218.78 | $776.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $5,370.32 | Facility | None | $812.83 | $3,467.37 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $4,265.80 Typical High $7,413.10 | Professional | None | $2,344.23 | $4,265.80 | $7,413.10 |
DeanCare Setting Facility Modifier None Typical Low $1,584.89 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,584.89 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $4,786.30 | Professional | None | $2,884.03 | $3,548.13 | $4,786.30 |
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 $1,737.80 Median $4,897.79 Typical High $7,943.28 | Professional | None | $1,737.80 | $4,897.79 | $7,943.28 |
Network Health Setting Facility Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,995.26 | $2,089.30 | $2,818.38 |
Network Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $4,466.84 | Professional | None | $1,995.26 | $3,388.44 | $4,466.84 |
Prevea360 Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,884.03 | Facility | None | $1,230.27 | $1,698.24 | $2,884.03 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $6,165.95 | Professional | None | $1,513.56 | $3,467.37 | $6,165.95 |
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 $2,344.23 Median $2,344.23 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,344.23 | $3,162.28 |
Security Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
Security Health Setting Professional Modifier None Typical Low $6,606.93 Median $8,709.64 Typical High $10,000.00 | Professional | None | $6,606.93 | $8,709.64 | $10,000.00 |
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 $1,621.81 Median $4,897.79 Typical High $7,585.78 | Professional | None | $1,621.81 | $4,897.79 | $7,585.78 |
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 $891.25 Median $891.25 Typical High $8,709.64 | Professional | 52 · Reduced service | $891.25 | $891.25 | $8,709.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $3,548.13 | Professional | 53 · Discontinued | $363.08 | $363.08 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $13,182.57 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $13,182.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $2,630.27 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $2,630.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $12,302.69 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $12,302.69 |
Where Wisconsin sits
The same service costs 5.6 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
$5,129
AK $5,754TX $1,023
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.