How much rates vary
Facilitymedian $5,623 · 10th to 90th $646 to $14,454Professionalmedian $955 · 10th to 90th $525 to $4,074
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 $524.81 Median $524.81 Typical High $14,454.40 | Facility | None | $524.81 | $524.81 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $20,417.38 | Professional | None | $501.19 | $524.81 | $20,417.38 |
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 $512.86 Median $1,513.56 Typical High $3,548.13 | Professional | None | $512.86 | $1,513.56 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $954.99 Typical High $2,238.72 | Professional | 62 · Two surgeons | $323.59 | $954.99 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $239.88 Typical High $575.44 | Professional | 80 · Assistant surgeon | $77.62 | $239.88 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $213.80 Typical High $501.19 | Professional | AS · PA/NP assist | $72.44 | $213.80 | $501.19 |
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 $851.14 Median $891.25 Typical High $1,949.84 | Professional | None | $851.14 | $891.25 | $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 $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 $562.34 Median $1,584.89 Typical High $16,595.87 | Professional | None | $562.34 | $1,584.89 | $16,595.87 |
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 $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,621.81 | $1,698.24 | $1,698.24 |
Prevea360 Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $1,047.13 | Facility | None | $489.78 | $588.84 | $1,047.13 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,479.11 | Professional | None | $501.19 | $1,000.00 | $1,479.11 |
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 $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
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 $501.19 Median $851.14 Typical High $2,290.87 | Professional | None | $501.19 | $851.14 | $2,290.87 |
4 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 $371.54 Median $398.11 Typical High $15,135.61 | Professional | 54 · Surgery only | $371.54 | $398.11 | $15,135.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $3,019.95 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $3,019.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $2,041.74 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $2,041.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $14,125.38 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $14,125.38 |
Where Wisconsin sits
The same service costs 11.7 times more in New York than in North Carolina. 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
$1,047
NY $3,802NC $324
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.