How much rates vary
Facilitymedian $5,129 · 10th to 90th $479 to $15,136Professionalmedian $468 · 10th to 90th $251 to $1,950
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 $251.19 Median $251.19 Typical High $14,454.40 | Facility | None | $251.19 | $251.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $2,344.23 | Professional | None | $251.19 | $251.19 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,317.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $758.58 Typical High $1,778.28 | Professional | None | $245.47 | $758.58 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $467.74 Typical High $1,122.02 | Professional | 62 · Two surgeons | $154.88 | $467.74 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $117.49 Typical High $288.40 | Professional | 80 · Assistant surgeon | $39.81 | $117.49 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $104.71 Typical High $251.19 | Professional | AS · PA/NP assist | $34.67 | $104.71 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $676.08 Typical High $1,479.11 | Facility | None | $588.84 | $676.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $954.99 | Professional | None | $354.81 | $426.58 | $954.99 |
DeanCare Setting Facility Modifier None Typical Low $251.19 Median $7,943.28 Typical High $14,454.40 | Facility | None | $251.19 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $812.83 | Professional | None | $398.11 | $467.74 | $812.83 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $295.12 Typical High $512.86 | Professional | 62 · Two surgeons | $251.19 | $295.12 | $512.86 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $74.13 Typical High $128.82 | Professional | 80 · Assistant surgeon | $63.10 | $74.13 | $128.82 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $64.57 Typical High $112.20 | Professional | AS · PA/NP assist | $54.95 | $64.57 | $112.20 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $2,454.71 Typical High $18,197.01 | Facility | None | $389.05 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $870.96 Typical High $4,365.16 | Professional | None | $288.40 | $870.96 | $4,365.16 |
Network Health Setting Facility Modifier None Typical Low $338.84 Median $467.74 Typical High $2,089.30 | Facility | None | $338.84 | $467.74 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $676.08 | Professional | None | $316.23 | $524.81 | $676.08 |
Prevea360 Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $512.86 | Facility | None | $208.93 | $263.03 | $512.86 |
Quartz Setting Professional Modifier None Typical Low $239.88 Median $478.63 Typical High $977.24 | Professional | None | $239.88 | $478.63 | $977.24 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,691.53 | Facility | None | $758.58 | $1,023.29 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $537.03 | Professional | None | $371.54 | $426.58 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,288.25 | Professional | None | $758.58 | $1,000.00 | $1,288.25 |
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 $245.47 Median $416.87 Typical High $1,071.52 | Professional | None | $245.47 | $416.87 | $1,071.52 |
7 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 $125.89 Median $125.89 Typical High $1,174.90 | Professional | 52 · Reduced service | $125.89 | $125.89 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $467.74 | Professional | 53 · Discontinued | $50.12 | $50.12 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $1,778.28 | Professional | 54 · Surgery only | $186.21 | $186.21 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $354.81 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $234.42 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $234.42 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $63.10 Median $74.13 Typical High $128.82 | Professional | 81 · Minimal assistant surgeon | $63.10 | $74.13 | $128.82 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $63.10 Median $74.13 Typical High $128.82 | Professional | 82 · Assistant surgeon, no resident | $63.10 | $74.13 | $128.82 |
Where Wisconsin sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 4th of 51
$525
AK $977UT $195
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.