How much rates vary
Facilitymedian $5,129 · 10th to 90th $776 to $16,218Professionalmedian $2,188 · 10th to 90th $1,202 to $8,511
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 $1,202.26 Median $1,202.26 Typical High $14,454.40 | Facility | None | $1,202.26 | $1,202.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $14,454.40 | Professional | None | $1,202.26 | $1,202.26 | $14,454.40 |
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 $1,096.48 Median $3,801.89 Typical High $8,511.38 | Professional | None | $1,096.48 | $3,801.89 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $2,344.23 Typical High $5,370.32 | Professional | 62 · Two surgeons | $691.83 | $2,344.23 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $602.56 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $173.78 | $602.56 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $524.81 Typical High $1,202.26 | Professional | AS · PA/NP assist | $151.36 | $524.81 | $1,202.26 |
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 $1,621.81 Median $2,187.76 Typical High $4,365.16 | Professional | None | $1,621.81 | $2,187.76 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,025.60 | Facility | None | $1,288.25 | $3,311.31 | $6,025.60 |
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 $1,258.93 Median $3,388.44 Typical High $8,511.38 | Professional | None | $1,258.93 | $3,388.44 | $8,511.38 |
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 |
Network Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,073.80 | $4,265.80 | $4,265.80 |
Prevea360 Setting Facility Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $2,398.83 | Facility | None | $1,202.26 | $1,288.25 | $2,398.83 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,148.15 | $2,290.87 | $3,630.78 |
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 $2,187.76 Median $2,187.76 Typical High $2,454.71 | Professional | None | $2,187.76 | $2,187.76 | $2,454.71 |
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 $1,071.52 Median $1,905.46 Typical High $4,677.35 | Professional | None | $1,071.52 | $1,905.46 | $4,677.35 |
3 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 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $10,964.78 | Professional | 54 · Surgery only | $912.01 | $912.01 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $2,187.76 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $1,445.44 |
Where Wisconsin sits
The same service costs 5.6 times more in Alaska than in New York. 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· 7th of 51
$2,239
AK $4,786NY $851
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.