How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,698 to $15,136Professionalmedian $3,162 · 10th to 90th $1,148 to $6,607
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 $1,148.15 Median $11,220.18 Typical High $14,454.40 | Facility | None | $1,148.15 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $11,220.18 | Professional | None | $1,148.15 | $1,148.15 | $11,220.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $7,585.78 | Professional | None | $1,000.00 | $3,630.78 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $2,290.87 Typical High $4,570.88 | Professional | 62 · Two surgeons | $630.96 | $2,290.87 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $588.84 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $162.18 | $588.84 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $501.19 Typical High $1,023.29 | Professional | AS · PA/NP assist | $141.25 | $501.19 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $3,801.89 Typical High $7,943.28 | Facility | None | $2,238.72 | $3,801.89 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $4,786.30 | Professional | None | $1,513.56 | $2,754.23 | $4,786.30 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $7,943.28 Typical High $14,454.40 | Facility | None | $954.99 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,290.87 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $7,943.28 Typical High $16,595.87 | Facility | None | $1,202.26 | $7,943.28 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $3,235.94 Typical High $5,248.07 | Professional | None | $1,148.15 | $3,235.94 | $5,248.07 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,258.93 | $2,187.76 | $3,019.95 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,737.80 | Facility | None | $933.25 | $1,023.29 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $2,187.76 Typical High $4,073.80 | Professional | None | $954.99 | $2,187.76 | $4,073.80 |
Quartz Setting Facility Modifier None Typical Low $1,995.26 Median $5,754.40 Typical High $8,709.64 | Facility | None | $1,995.26 | $5,754.40 | $8,709.64 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $5,623.41 Typical High $6,456.54 | Professional | None | $4,265.80 | $5,623.41 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $3,235.94 Typical High $5,011.87 | Professional | None | $1,071.52 | $3,235.94 | $5,011.87 |
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 $575.44 Median $575.44 Typical High $5,623.41 | Professional | 52 · Reduced service | $575.44 | $575.44 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $2,238.72 | Professional | 53 · Discontinued | $229.09 | $229.09 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $8,511.38 | Professional | 54 · Surgery only | $870.96 | $870.96 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $1,698.24 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $7,943.28 |
Where Wisconsin sits
The same service costs 4.0 times more in Wisconsin than in Montana. 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.
Physician feeFacility fee
WI $11,674MT $2,925
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.