How much rates vary
Facilitymedian $6,761 · 10th to 90th $912 to $16,982Professionalmedian $4,365 · 10th to 90th $1,622 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 $1,621.81 Median $1,621.81 Typical High $14,454.40 | Facility | None | $1,621.81 | $1,621.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $13,489.63 | Professional | None | $1,621.81 | $1,621.81 | $13,489.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,606.93 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $5,011.87 Typical High $10,715.19 | Professional | None | $1,412.54 | $5,011.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $7,585.78 Typical High $15,488.17 | Professional | 50 · Both sides | $2,137.96 | $7,585.78 | $15,488.17 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $3,162.28 Typical High $6,456.54 | Professional | 62 · Two surgeons | $891.25 | $3,162.28 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $794.33 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $223.87 | $794.33 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $707.95 Typical High $1,445.44 | Professional | AS · PA/NP assist | $199.53 | $707.95 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $4,786.30 | Facility | None | $812.83 | $3,162.28 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,890.45 Typical High $6,760.83 | Professional | None | $2,137.96 | $3,890.45 | $6,760.83 |
DeanCare Setting Facility Modifier None Typical Low $1,412.54 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,412.54 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,630.27 Median $3,235.94 Typical High $4,365.16 | Professional | None | $2,630.27 | $3,235.94 | $4,365.16 |
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 $1,584.89 Median $4,466.84 Typical High $7,244.36 | Professional | None | $1,584.89 | $4,466.84 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,691.53 | Facility | None | $1,819.70 | $2,089.30 | $2,691.53 |
Network Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,090.30 Typical High $4,365.16 | Professional | None | $1,778.28 | $3,090.30 | $4,365.16 |
Prevea360 Setting Facility Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,691.53 | Facility | None | $1,122.02 | $1,548.82 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,623.41 | Professional | None | $1,348.96 | $3,090.30 | $5,623.41 |
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 $2,137.96 Median $2,137.96 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,137.96 | $2,951.21 |
Security Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Security Health Setting Professional Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $8,912.51 | Professional | None | $5,888.44 | $7,943.28 | $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 $1,479.11 Median $4,466.84 Typical High $7,079.46 | Professional | None | $1,479.11 | $4,466.84 | $7,079.46 |
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 $812.83 Median $812.83 Typical High $6,760.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $6,760.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $2,691.53 | Professional | 53 · Discontinued | $323.59 | $323.59 | $2,691.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $10,232.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $10,232.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $2,041.74 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $2,041.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $1,348.96 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $1,348.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $9,549.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $9,549.93 |
Where Wisconsin sits
The same service costs 5.5 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
$4,786
AK $5,248TX $955
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.