How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $2,884 · 10th to 90th $933 to $6,761
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 $933.25 Median $933.25 Typical High $14,454.40 | Facility | None | $933.25 | $933.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $8,709.64 | Professional | None | $933.25 | $933.25 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,715.19 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $3,388.44 Typical High $7,079.46 | Professional | None | $1,096.48 | $3,388.44 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $2,137.96 Typical High $4,466.84 | Professional | 62 · Two surgeons | $691.83 | $2,137.96 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $537.03 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $177.83 | $537.03 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $467.74 Typical High $1,000.00 | Professional | AS · PA/NP assist | $154.88 | $467.74 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,344.23 Typical High $3,630.78 | Facility | None | $812.83 | $2,344.23 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,862.09 | $3,235.94 |
DeanCare Setting Facility Modifier None Typical Low $977.24 Median $7,943.28 Typical High $14,454.40 | Facility | None | $977.24 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,344.23 | $2,951.21 |
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 $1,023.29 Median $2,884.03 Typical High $6,025.60 | Professional | None | $1,023.29 | $2,884.03 | $6,025.60 |
Network Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,089.30 | Facility | None | $1,318.26 | $1,778.28 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,318.26 | $2,238.72 | $2,951.21 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,819.70 | Facility | None | $812.83 | $1,047.13 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $2,041.74 Typical High $3,801.89 | Professional | None | $891.25 | $2,041.74 | $3,801.89 |
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 $1,230.27 Median $1,230.27 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,230.27 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $6,918.31 | Professional | None | $4,265.80 | $5,248.07 | $6,918.31 |
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 $851.14 Median $2,511.89 Typical High $4,466.84 | Professional | None | $851.14 | $2,511.89 | $4,466.84 |
6 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 52 · Reduced service Typical Low $467.74 Median $467.74 Typical High $4,365.16 | Professional | 52 · Reduced service | $467.74 | $467.74 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $1,737.80 | Professional | 53 · Discontinued | $186.21 | $186.21 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $6,456.54 | Professional | 54 · Surgery only | $691.83 | $691.83 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $870.96 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $6,025.60 |
Where Wisconsin sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 2nd of 51
$3,162
AK $3,631UT $631
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.