How much rates vary
Facilitymedian $6,918 · 10th to 90th $912 to $16,982Professionalmedian $6,607 · 10th to 90th $2,399 to $14,125
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 $2,398.83 Median $2,398.83 Typical High $14,454.40 | Facility | None | $2,398.83 | $2,398.83 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $19,952.62 | Professional | None | $2,398.83 | $2,398.83 | $19,952.62 |
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 $2,041.74 Median $7,413.10 Typical High $15,488.17 | Professional | None | $2,041.74 | $7,413.10 | $15,488.17 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $10,964.78 Typical High $23,442.29 | Professional | 50 · Both sides | $3,090.30 | $10,964.78 | $23,442.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $4,677.35 Typical High $9,772.37 | Professional | 62 · Two surgeons | $1,288.25 | $4,677.35 | $9,772.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $1,174.90 Typical High $2,511.89 | Professional | 80 · Assistant surgeon | $331.13 | $1,174.90 | $2,511.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $1,023.29 Typical High $2,187.76 | Professional | AS · PA/NP assist | $288.40 | $1,023.29 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,570.88 Typical High $7,079.46 | Facility | None | $812.83 | $4,570.88 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $5,623.41 Typical High $10,000.00 | Professional | None | $3,090.30 | $5,623.41 | $10,000.00 |
DeanCare Setting Facility Modifier None Typical Low $2,089.30 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,089.30 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,801.89 Median $4,677.35 Typical High $6,760.83 | Professional | None | $3,801.89 | $4,677.35 | $6,760.83 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,398.83 Median $6,918.31 Typical High $10,715.19 | Professional | None | $2,398.83 | $6,918.31 | $10,715.19 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $4,073.80 | Facility | None | $2,089.30 | $2,630.27 | $4,073.80 |
Network Health Setting Professional Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $6,456.54 | Professional | None | $2,630.27 | $4,677.35 | $6,456.54 |
Prevea360 Setting Facility Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $4,073.80 | Facility | None | $1,621.81 | $2,290.87 | $4,073.80 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $4,466.84 Typical High $8,709.64 | Professional | None | $1,949.84 | $4,466.84 | $8,709.64 |
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 $3,090.30 Median $3,090.30 Typical High $4,265.80 | Professional | None | $3,090.30 | $3,090.30 | $4,265.80 |
Security Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
Security Health Setting Professional Modifier None Typical Low $8,912.51 Median $11,481.54 Typical High $13,182.57 | Professional | None | $8,912.51 | $11,481.54 | $13,182.57 |
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 $2,187.76 Median $6,760.83 Typical High $10,715.19 | Professional | None | $2,187.76 | $6,760.83 | $10,715.19 |
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 $1,202.26 Median $1,202.26 Typical High $10,000.00 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $10,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $3,981.07 | Professional | 53 · Discontinued | $478.63 | $478.63 | $3,981.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $15,135.61 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $15,135.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $3,019.95 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $3,019.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $1,995.26 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $1,995.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $14,125.38 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $14,125.38 |
Where Wisconsin sits
The same service costs 5.1 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
$6,761
AK $7,762TX $1,514
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.