How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $4,571 · 10th to 90th $1,479 to $10,715
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 $1,479.11 Median $1,479.11 Typical High $14,454.40 | Facility | None | $1,479.11 | $1,479.11 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $14,125.38 | Professional | None | $1,479.11 | $1,479.11 | $14,125.38 |
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 $1,737.80 Median $5,370.32 Typical High $10,964.78 | Professional | None | $1,737.80 | $5,370.32 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $3,388.44 Typical High $6,918.31 | Professional | 62 · Two surgeons | $1,096.48 | $3,388.44 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $851.14 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $281.84 | $851.14 | $1,778.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $741.31 Typical High $1,548.82 | Professional | AS · PA/NP assist | $245.47 | $741.31 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $5,623.41 | Facility | None | $812.83 | $3,630.78 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,951.21 | $5,128.61 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,548.82 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $4,786.30 | Professional | None | $2,511.89 | $3,715.35 | $4,786.30 |
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 $1,659.59 Median $4,168.69 Typical High $9,332.54 | Professional | None | $1,659.59 | $4,168.69 | $9,332.54 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Facility | None | $2,089.30 | $2,089.30 | $2,884.03 |
Network Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,548.13 Typical High $4,677.35 | Professional | None | $2,041.74 | $3,548.13 | $4,677.35 |
Prevea360 Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,019.95 | Facility | None | $1,288.25 | $1,659.59 | $3,019.95 |
Quartz Setting Professional Modifier None Typical Low $1,513.56 Median $3,548.13 Typical High $6,025.60 | Professional | None | $1,513.56 | $3,548.13 | $6,025.60 |
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 $1,905.46 Median $1,905.46 Typical High $4,466.84 | Professional | None | $1,905.46 | $1,905.46 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
Security Health Setting Professional Modifier None Typical Low $7,079.46 Median $8,317.64 Typical High $10,964.78 | Professional | None | $7,079.46 | $8,317.64 | $10,964.78 |
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 $1,380.38 Median $3,890.45 Typical High $7,079.46 | Professional | None | $1,380.38 | $3,890.45 | $7,079.46 |
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 $724.44 Median $724.44 Typical High $6,918.31 | Professional | 52 · Reduced service | $724.44 | $724.44 | $6,918.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $2,818.38 | Professional | 53 · Discontinued | $295.12 | $295.12 | $2,818.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $10,471.29 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $10,471.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $2,089.30 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $1,412.54 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $1,412.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $9,772.37 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $9,772.37 |
Where Wisconsin sits
The same service costs 5.6 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
$4,677
AK $6,026UT $1,072
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.