How much rates vary
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 $1,174.90 Median $9,549.93 Typical High $14,454.40 | Facility | None | $1,174.90 | $9,549.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $12,589.25 | Professional | None | $1,174.90 | $1,174.90 | $12,589.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,317.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $4,265.80 Typical High $8,912.51 | Professional | None | $1,412.54 | $4,265.80 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $2,691.53 Typical High $5,623.41 | Professional | 62 · Two surgeons | $891.25 | $2,691.53 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $691.83 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $223.87 | $691.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $602.56 Typical High $1,258.93 | Professional | AS · PA/NP assist | $194.98 | $602.56 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $4,570.88 | Facility | None | $812.83 | $2,951.21 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,344.23 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,230.27 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,230.27 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $3,801.89 | Professional | None | $2,041.74 | $3,019.95 | $3,801.89 |
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 $1,318.26 Median $3,630.78 Typical High $7,762.47 | Professional | None | $1,318.26 | $3,630.78 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,238.72 | Facility | None | $1,659.59 | $2,089.30 | $2,238.72 |
Network Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,818.38 | $3,715.35 |
Prevea360 Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,344.23 | Facility | None | $1,047.13 | $1,318.26 | $2,344.23 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $4,897.79 | Professional | None | $1,122.02 | $2,570.40 | $4,897.79 |
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 $1,548.82 Median $1,548.82 Typical High $3,630.78 | Professional | None | $1,548.82 | $1,548.82 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Security Health Setting Professional Modifier None Typical Low $5,495.41 Median $6,760.83 Typical High $8,709.64 | Professional | None | $5,495.41 | $6,760.83 | $8,709.64 |
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 $1,096.48 Median $3,162.28 Typical High $5,754.40 | Professional | None | $1,096.48 | $3,162.28 | $5,754.40 |
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 $588.84 Median $588.84 Typical High $6,309.57 | Professional | 52 · Reduced service | $588.84 | $588.84 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $2,511.89 | Professional | 53 · Discontinued | $234.42 | $234.42 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $9,332.54 | Professional | 54 · Surgery only | $891.25 | $891.25 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $1,905.46 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $8,709.64 |
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
$3,890
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.