How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $14,454Professionalmedian $813 · 10th to 90th $380 to $3,388
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 $380.19 Median $380.19 Typical High $14,454.40 | Facility | None | $380.19 | $380.19 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $8,511.38 | Professional | None | $380.19 | $380.19 | $8,511.38 |
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 $407.38 Median $1,202.26 Typical High $2,884.03 | Professional | None | $407.38 | $1,202.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $758.58 Typical High $1,819.70 | Professional | 62 · Two surgeons | $257.04 | $758.58 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $190.55 Typical High $457.09 | Professional | 80 · Assistant surgeon | $64.57 | $190.55 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $165.96 Typical High $398.11 | Professional | AS · PA/NP assist | $54.95 | $165.96 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $2,691.53 | Facility | None | $812.83 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,949.84 | Professional | None | $676.08 | $741.31 | $1,949.84 |
DeanCare Setting Facility Modifier None Typical Low $588.84 Median $7,943.28 Typical High $14,791.08 | Facility | None | $588.84 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,445.44 Typical High $16,218.10 | Professional | None | $489.78 | $1,445.44 | $16,218.10 |
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 $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,380.38 | $1,380.38 |
Prevea360 Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $1,000.00 | Facility | None | $389.05 | $588.84 | $1,000.00 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $1,148.15 | Professional | None | $363.08 | $724.44 | $1,148.15 |
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 $741.31 Median $741.31 Typical High $812.83 | Professional | None | $741.31 | $741.31 | $812.83 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,691.53 | $2,951.21 |
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 $380.19 Median $741.31 Typical High $2,290.87 | Professional | None | $380.19 | $741.31 | $2,290.87 |
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 $281.84 Median $281.84 Typical High $6,309.57 | Professional | 54 · Surgery only | $281.84 | $281.84 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $1,258.93 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $851.14 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $851.14 |
Where Wisconsin sits
The same service costs 15.1 times more in New York 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· 7th of 51
$955
NY $3,802HI $251
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.