How much rates vary
Facilitymedian $6,918 · 10th to 90th $912 to $16,982Professionalmedian $5,888 · 10th to 90th $2,138 to $12,303
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 $2,137.96 Median $2,137.96 Typical High $14,454.40 | Facility | None | $2,137.96 | $2,137.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $16,982.44 | Professional | None | $2,137.96 | $2,137.96 | $16,982.44 |
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 $1,862.09 Median $6,606.93 Typical High $14,125.38 | Professional | None | $1,862.09 | $6,606.93 | $14,125.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $10,000.00 Typical High $19,498.45 | Professional | 50 · Both sides | $2,818.38 | $10,000.00 | $19,498.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $4,168.69 Typical High $8,128.31 | Professional | 62 · Two surgeons | $1,174.90 | $4,168.69 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $1,047.13 Typical High $2,089.30 | Professional | 80 · Assistant surgeon | $302.00 | $1,047.13 | $2,089.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $933.25 Typical High $1,819.70 | Professional | AS · PA/NP assist | $263.03 | $933.25 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $6,456.54 | Facility | None | $812.83 | $4,168.69 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $5,128.61 Typical High $8,912.51 | Professional | None | $2,818.38 | $5,128.61 | $8,912.51 |
DeanCare Setting Facility Modifier None Typical Low $1,905.46 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,905.46 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,467.37 Median $4,265.80 Typical High $5,754.40 | Professional | None | $3,467.37 | $4,265.80 | $5,754.40 |
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 $2,089.30 Median $5,888.44 Typical High $9,549.93 | Professional | None | $2,089.30 | $5,888.44 | $9,549.93 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $3,467.37 | Facility | None | $2,089.30 | $2,398.83 | $3,467.37 |
Network Health Setting Professional Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $5,495.41 | Professional | None | $2,344.23 | $4,073.80 | $5,495.41 |
Prevea360 Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,630.78 | Facility | None | $1,479.11 | $2,041.74 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,819.70 Median $4,168.69 Typical High $7,413.10 | Professional | None | $1,819.70 | $4,168.69 | $7,413.10 |
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 $2,818.38 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,818.38 | $2,818.38 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Security Health Setting Professional Modifier None Typical Low $7,762.47 Median $10,471.29 Typical High $12,022.64 | Professional | None | $7,762.47 | $10,471.29 | $12,022.64 |
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 $1,949.84 Median $5,888.44 Typical High $9,120.11 | Professional | None | $1,949.84 | $5,888.44 | $9,120.11 |
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 $1,071.52 Median $1,071.52 Typical High $8,511.38 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $8,511.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $3,467.37 | Professional | 53 · Discontinued | $426.58 | $426.58 | $3,467.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $12,882.50 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $12,882.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $2,570.40 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $1,698.24 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $1,698.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $12,022.64 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $12,022.64 |
Where Wisconsin sits
The same service costs 5.8 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
$6,166
AK $6,918TX $1,202
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.