How much rates vary
Facilitymedian $6,761 · 10th to 90th $912 to $16,982Professionalmedian $5,248 · 10th to 90th $1,950 to $11,220
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 $15,848.93 | Professional | None | $1,949.84 | $1,949.84 | $15,848.93 |
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 $1,698.24 Median $6,025.60 Typical High $12,882.50 | Professional | None | $1,698.24 | $6,025.60 | $12,882.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $8,912.51 Typical High $18,620.87 | Professional | 50 · Both sides | $2,511.89 | $8,912.51 | $18,620.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $3,801.89 Typical High $7,943.28 | Professional | 62 · Two surgeons | $1,071.52 | $3,801.89 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $954.99 Typical High $1,995.26 | Professional | 80 · Assistant surgeon | $269.15 | $954.99 | $1,995.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $851.14 Typical High $1,737.80 | Professional | AS · PA/NP assist | $234.42 | $851.14 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,715.35 Typical High $5,754.40 | Facility | None | $812.83 | $3,715.35 | $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 $1,949.84 Median $5,370.32 Typical High $8,709.64 | Professional | None | $1,949.84 | $5,370.32 | $8,709.64 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $3,235.94 | Facility | None | $2,089.30 | $2,187.76 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,715.35 Typical High $5,128.61 | Professional | None | $2,137.96 | $3,715.35 | $5,128.61 |
Prevea360 Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,862.09 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,760.83 | Professional | None | $1,621.81 | $3,715.35 | $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 $7,943.28 | Professional | 52 · Reduced service | $977.24 | $977.24 | $7,943.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $3,235.94 | Professional | 53 · Discontinued | $389.05 | $389.05 | $3,235.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $12,022.64 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $12,022.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $2,398.83 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $2,398.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $1,584.89 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $11,220.18 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $11,220.18 |
Where Wisconsin sits
The same service costs 5.9 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
$5,623
AK $6,310TX $1,072
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.