How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,148 to $11,220Professionalmedian $2,344 · 10th to 90th $832 to $4,898
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 $933.25 Median $933.25 Typical High $14,454.40 | Facility | None | $933.25 | $933.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $8,912.51 | Professional | None | $933.25 | $933.25 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $2,630.27 Typical High $5,128.61 | Professional | None | $794.33 | $2,630.27 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $416.87 Typical High $812.83 | Professional | 80 · Assistant surgeon | $125.89 | $416.87 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $363.08 Typical High $707.95 | Professional | AS · PA/NP assist | $112.20 | $363.08 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $4,073.80 | Facility | None | $1,023.29 | $2,398.83 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,318.26 | $2,187.76 | $3,801.89 |
DeanCare Setting Facility Modifier None Typical Low $758.58 Median $7,943.28 Typical High $14,454.40 | Facility | None | $758.58 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,862.09 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $4,570.88 Typical High $10,964.78 | Facility | None | $870.96 | $4,570.88 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $2,344.23 Typical High $3,801.89 | Professional | None | $758.58 | $2,344.23 | $3,801.89 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,445.44 | $2,187.76 |
Prevea360 Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $1,445.44 | Facility | None | $616.60 | $812.83 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $3,019.95 | Professional | None | $851.14 | $1,949.84 | $3,019.95 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $4,466.84 | Facility | None | $812.83 | $2,691.53 | $4,466.84 |
Quartz Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,318.26 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Security Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $4,897.79 | Professional | None | $2,511.89 | $4,365.16 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $758.58 Median $2,398.83 Typical High $3,715.35 | Professional | None | $758.58 | $2,398.83 | $3,715.35 |
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 $467.74 Median $467.74 Typical High $4,466.84 | Professional | 52 · Reduced service | $467.74 | $467.74 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $1,778.28 | Professional | 53 · Discontinued | $186.21 | $186.21 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $6,606.93 | Professional | 54 · Surgery only | $691.83 | $691.83 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $1,318.26 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $891.25 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $6,165.95 |
Where Wisconsin sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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· 3rd of 51
$2,951
OK $4,169KY $617
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.