How much rates vary
Facilitymedian $5,623 · 10th to 90th $468 to $14,454Professionalmedian $589 · 10th to 90th $200 to $1,445
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 $199.53 Median $199.53 Typical High $14,454.40 | Facility | None | $199.53 | $199.53 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $5,623.41 | Professional | None | $199.53 | $199.53 | $5,623.41 |
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 $234.42 Median $724.44 Typical High $1,513.56 | Professional | None | $234.42 | $724.44 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $457.09 Typical High $954.99 | Professional | 62 · Two surgeons | $147.91 | $457.09 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $117.49 Typical High $245.47 | Professional | 80 · Assistant surgeon | $37.15 | $117.49 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $102.33 Typical High $213.80 | Professional | AS · PA/NP assist | $33.11 | $102.33 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $616.60 Typical High $1,584.89 | Facility | None | $467.74 | $616.60 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $660.69 | Professional | None | $263.03 | $354.81 | $660.69 |
DeanCare Setting Facility Modifier None Typical Low $204.17 Median $7,943.28 Typical High $14,791.08 | Facility | None | $204.17 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $2,454.71 Typical High $18,197.01 | Facility | None | $316.23 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $457.09 Typical High $1,122.02 | Professional | None | $169.82 | $457.09 | $1,122.02 |
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 $588.84 Median $676.08 Typical High $676.08 | Professional | None | $588.84 | $676.08 | $676.08 |
Prevea360 Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $426.58 | Facility | None | $169.82 | $204.17 | $426.58 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $426.58 Typical High $630.96 | Professional | None | $204.17 | $426.58 | $630.96 |
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 $263.03 Median $263.03 Typical High $588.84 | Professional | None | $263.03 | $263.03 | $588.84 |
Security Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,096.48 | $1,479.11 |
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 $169.82 Median $489.78 Typical High $912.01 | Professional | None | $169.82 | $489.78 | $912.01 |
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 $151.36 Median $151.36 Typical High $4,168.69 | Professional | 54 · Surgery only | $151.36 | $151.36 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $831.76 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $562.34 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $562.34 |
Where Wisconsin sits
The same service costs 10.5 times more in North Dakota than in Kentucky. 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
$741
ND $2,239KY $214
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.