How much rates vary
Facilitymedian $5,623 · 10th to 90th $513 to $14,454Professionalmedian $490 · 10th to 90th $263 to $2,239
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 $269.15 Median $269.15 Typical High $14,454.40 | Facility | None | $269.15 | $269.15 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $7,244.36 | Professional | None | $269.15 | $269.15 | $7,244.36 |
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 $251.19 Median $794.33 Typical High $1,819.70 | Professional | None | $251.19 | $794.33 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $158.49 Median $501.19 Typical High $1,148.15 | Professional | 62 · Two surgeons | $158.49 | $501.19 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $128.82 Typical High $295.12 | Professional | 80 · Assistant surgeon | $40.74 | $128.82 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $112.20 Typical High $257.04 | Professional | AS · PA/NP assist | $35.48 | $112.20 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $758.58 Typical High $1,584.89 | Facility | None | $630.96 | $758.58 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $954.99 | Professional | None | $398.11 | $489.78 | $954.99 |
DeanCare Setting Facility Modifier None Typical Low $275.42 Median $7,943.28 Typical High $14,791.08 | Facility | None | $275.42 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $2,454.71 Typical High $18,197.01 | Facility | None | $407.38 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $724.44 Typical High $4,365.16 | Professional | None | $263.03 | $724.44 | $4,365.16 |
Network Health Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | None | $851.14 | $870.96 | $870.96 |
Prevea360 Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $478.63 | Facility | None | $229.09 | $275.42 | $478.63 |
Quartz Setting Professional Modifier None Typical Low $257.04 Median $512.86 Typical High $776.25 | Professional | None | $257.04 | $512.86 | $776.25 |
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 $489.78 Median $489.78 Typical High $537.03 | Professional | None | $489.78 | $489.78 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Security Health Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,348.96 | Professional | None | $954.99 | $1,230.27 | $1,348.96 |
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 $234.42 Median $380.19 Typical High $1,047.13 | Professional | None | $234.42 | $380.19 | $1,047.13 |
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 $199.53 Median $199.53 Typical High $5,495.41 | Professional | 54 · Surgery only | $199.53 | $199.53 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $1,096.48 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $724.44 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $724.44 |
Where Wisconsin sits
The same service costs 8.1 times more in New York than in Missouri. 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
$589
NY $1,820MO $224
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.