How much rates vary
Facilitymedian $6,761 · 10th to 90th $912 to $16,982Professionalmedian $5,623 · 10th to 90th $2,089 to $12,589
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 $2,089.30 Median $2,089.30 Typical High $14,454.40 | Facility | None | $2,089.30 | $2,089.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $16,982.44 | Professional | None | $2,089.30 | $2,089.30 | $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 $1,819.70 Median $6,456.54 Typical High $13,182.57 | Professional | None | $1,819.70 | $6,456.54 | $13,182.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $9,549.93 Typical High $19,498.45 | Professional | 50 · Both sides | $2,691.53 | $9,549.93 | $19,498.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $4,073.80 Typical High $8,317.64 | Professional | 62 · Two surgeons | $1,148.15 | $4,073.80 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $1,023.29 Typical High $2,089.30 | Professional | 80 · Assistant surgeon | $288.40 | $1,023.29 | $2,089.30 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $891.25 Typical High $1,819.70 | Professional | AS · PA/NP assist | $251.19 | $891.25 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,981.07 Typical High $6,165.95 | Facility | None | $812.83 | $3,981.07 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $8,709.64 | Professional | None | $2,691.53 | $4,897.79 | $8,709.64 |
DeanCare Setting Facility Modifier None Typical Low $1,819.70 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,819.70 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $5,623.41 | Professional | None | $3,311.31 | $4,073.80 | $5,623.41 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,511.89 Typical High $18,197.01 | Facility | None | $436.52 | $2,511.89 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $5,754.40 Typical High $9,332.54 | Professional | None | $2,137.96 | $5,754.40 | $9,332.54 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,388.44 | Facility | None | $2,089.30 | $2,344.23 | $3,388.44 |
Network Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,981.07 Typical High $5,495.41 | Professional | None | $2,290.87 | $3,981.07 | $5,495.41 |
Prevea360 Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,412.54 | $1,995.26 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $1,737.80 Median $3,981.07 Typical High $7,244.36 | Professional | None | $1,737.80 | $3,981.07 | $7,244.36 |
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 $2,691.53 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,691.53 | $2,691.53 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Security Health Setting Professional Modifier None Typical Low $7,585.78 Median $10,232.93 Typical High $11,481.54 | Professional | None | $7,585.78 | $10,232.93 | $11,481.54 |
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 $1,905.46 Median $5,754.40 Typical High $8,912.51 | Professional | None | $1,905.46 | $5,754.40 | $8,912.51 |
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 $1,047.13 Median $1,047.13 Typical High $8,511.38 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $8,511.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $3,388.44 | Professional | 53 · Discontinued | $416.87 | $416.87 | $3,388.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $12,882.50 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $12,882.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $2,570.40 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $1,698.24 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $1,698.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $12,022.64 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $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
$6,026
AK $6,761TX $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.