How much rates vary
Facilitymedian $6,457 · 10th to 90th $813 to $17,378Professionalmedian $5,248 · 10th to 90th $1,950 to $10,965
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 $1,949.84 Median $1,949.84 Typical High $14,454.40 | Facility | None | $1,949.84 | $1,949.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $17,782.79 | Professional | None | $1,949.84 | $1,949.84 | $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 $1,659.59 Median $6,025.60 Typical High $12,022.64 | Professional | None | $1,659.59 | $6,025.60 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $8,709.64 Typical High $18,197.01 | Professional | 50 · Both sides | $2,511.89 | $8,709.64 | $18,197.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $3,715.35 Typical High $7,585.78 | Professional | 62 · Two surgeons | $1,047.13 | $3,715.35 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $933.25 Typical High $1,949.84 | Professional | 80 · Assistant surgeon | $263.03 | $933.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $831.76 Typical High $1,698.24 | Professional | AS · PA/NP assist | $234.42 | $831.76 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,801.89 Typical High $5,754.40 | Facility | None | $812.83 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $8,128.31 | Professional | None | $2,511.89 | $4,570.88 | $8,128.31 |
DeanCare Setting Facility Modifier None Typical Low $1,698.24 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,698.24 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $5,248.07 | Professional | None | $3,090.30 | $3,890.45 | $5,248.07 |
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 $1,862.09 Median $5,248.07 Typical High $8,511.38 | Professional | None | $1,862.09 | $5,248.07 | $8,511.38 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,884.03 | Facility | None | $2,089.30 | $2,187.76 | $2,884.03 |
Network Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,630.78 Typical High $4,897.79 | Professional | None | $2,137.96 | $3,630.78 | $4,897.79 |
Prevea360 Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,235.94 | Facility | None | $1,348.96 | $1,862.09 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $1,659.59 Median $3,801.89 Typical High $6,760.83 | Professional | None | $1,659.59 | $3,801.89 | $6,760.83 |
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 $2,511.89 Median $2,511.89 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,511.89 | $3,467.37 |
Security Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Security Health Setting Professional Modifier None Typical Low $7,079.46 Median $9,549.93 Typical High $10,715.19 | Professional | None | $7,079.46 | $9,549.93 | $10,715.19 |
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 $1,778.28 Median $5,370.32 Typical High $8,317.64 | Professional | None | $1,778.28 | $5,370.32 | $8,317.64 |
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 $977.24 Median $977.24 Typical High $8,912.51 | Professional | 52 · Reduced service | $977.24 | $977.24 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $3,548.13 | Professional | 53 · Discontinued | $389.05 | $389.05 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $13,182.57 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $13,182.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $2,630.27 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $2,630.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $12,302.69 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $12,302.69 |
Where Wisconsin sits
The same service costs 5.2 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
$5,495
AK $6,166TX $1,175
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.