How much rates vary
Facilitymedian $6,026 · 10th to 90th $759 to $16,218Professionalmedian $6,026 · 10th to 90th $1,148 to $17,783
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 $6,025.60 Median $6,025.60 Typical High $14,454.40 | Facility | None | $6,025.60 | $6,025.60 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $17,782.79 | Professional | None | $6,025.60 | $6,025.60 | $17,782.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3,019.95 Median $3,019.95 Typical High $8,912.51 | Professional | 52 · Reduced service | $3,019.95 | $3,019.95 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,230.27 Typical High $3,548.13 | Professional | 53 · Discontinued | $1,230.27 | $1,230.27 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,570.88 Median $4,570.88 Typical High $13,182.57 | Professional | 54 · Surgery only | $4,570.88 | $4,570.88 | $13,182.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $912.01 Typical High $2,691.53 | Professional | 55 · Aftercare only | $912.01 | $912.01 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $602.56 Median $602.56 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $602.56 | $602.56 | $1,778.28 |
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 $870.96 Median $1,122.02 Typical High $1,318.26 | Professional | None | $870.96 | $1,122.02 | $1,318.26 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $1,122.02 | Professional | None | $363.08 | $724.44 | $1,122.02 |
DeanCare Setting Facility Modifier None Typical Low $6,165.95 Median $8,128.31 Typical High $14,791.08 | Facility | None | $6,165.95 | $8,128.31 | $14,791.08 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $2,454.71 Typical High $18,197.01 | Facility | None | $426.58 | $2,454.71 | $18,197.01 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $363.08 Median $630.96 Typical High $812.83 | Professional | None | $363.08 | $630.96 | $812.83 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $177.83 Typical High $199.53 | Professional | 80 · Assistant surgeon | $138.04 | $177.83 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $158.49 Typical High $173.78 | Professional | AS · PA/NP assist | $120.23 | $158.49 | $173.78 |
Where Wisconsin sits
The same service costs 204.2 times more in Wisconsin than in Hawaii. 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· 1st of 51
$6,026
WI $6,026HI $29.51
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.