How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,230 to $11,220Professionalmedian $3,236 · 10th to 90th $1,175 to $7,762
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 $1,174.90 Median $1,174.90 Typical High $14,454.40 | Facility | None | $1,174.90 | $1,174.90 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $10,471.29 | Professional | None | $1,174.90 | $1,174.90 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $3,715.35 Typical High $7,762.47 | Professional | None | $1,023.29 | $3,715.35 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $2,344.23 Typical High $4,897.79 | Professional | 62 · Two surgeons | $645.65 | $2,344.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $588.84 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $165.96 | $588.84 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $524.81 Typical High $1,096.48 | Professional | AS · PA/NP assist | $144.54 | $524.81 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,630.27 Typical High $4,265.80 | Facility | None | $1,023.29 | $2,630.27 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,897.79 | Professional | None | $1,548.82 | $2,818.38 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,047.13 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,344.23 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $4,570.88 Typical High $10,964.78 | Facility | None | $1,047.13 | $4,570.88 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $3,388.44 Typical High $5,248.07 | Professional | None | $1,202.26 | $3,388.44 | $5,248.07 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,288.25 | $2,344.23 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,995.26 | Facility | None | $812.83 | $1,122.02 | $1,995.26 |
Quartz Setting Professional Modifier None Typical Low $977.24 Median $2,238.72 Typical High $4,073.80 | Professional | None | $977.24 | $2,238.72 | $4,073.80 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $4,466.84 | Facility | None | $812.83 | $2,691.53 | $4,466.84 |
Quartz Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,548.82 | $2,137.96 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $6,456.54 | Professional | None | $4,897.79 | $6,165.95 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $5,128.61 | Professional | None | $1,071.52 | $3,235.94 | $5,128.61 |
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 $588.84 Median $588.84 Typical High $5,248.07 | Professional | 52 · Reduced service | $588.84 | $588.84 | $5,248.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $2,089.30 | Professional | 53 · Discontinued | $234.42 | $234.42 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $7,762.47 | Professional | 54 · Surgery only | $891.25 | $891.25 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $1,548.82 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $7,244.36 |
Where Wisconsin sits
The same service costs 4.6 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
$3,981
WI $3,981TX $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.