How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $16,218Professionalmedian $3,890 · 10th to 90th $1,259 to $9,333
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 $1,258.93 Median $1,258.93 Typical High $14,454.40 | Facility | None | $1,258.93 | $1,258.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $11,748.98 | Professional | None | $1,258.93 | $1,258.93 | $11,748.98 |
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 $1,513.56 Median $4,570.88 Typical High $9,549.93 | Professional | None | $1,513.56 | $4,570.88 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $6,918.31 Typical High $14,454.40 | Professional | 50 · Both sides | $2,238.72 | $6,918.31 | $14,454.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $2,884.03 Typical High $6,025.60 | Professional | 62 · Two surgeons | $954.99 | $2,884.03 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $741.31 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $239.88 | $741.31 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $645.65 Typical High $1,348.96 | Professional | AS · PA/NP assist | $208.93 | $645.65 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $4,897.79 | Facility | None | $812.83 | $3,162.28 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,570.40 | $4,365.16 |
DeanCare Setting Facility Modifier None Typical Low $1,348.96 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,348.96 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,073.80 | Professional | None | $2,187.76 | $3,235.94 | $4,073.80 |
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 $1,412.54 Median $3,890.45 Typical High $8,128.31 | Professional | None | $1,412.54 | $3,890.45 | $8,128.31 |
Network Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,398.83 | Facility | None | $1,778.28 | $2,089.30 | $2,398.83 |
Network Health Setting Professional Modifier None Typical Low $1,778.28 Median $3,090.30 Typical High $3,981.07 | Professional | None | $1,778.28 | $3,090.30 | $3,981.07 |
Prevea360 Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,454.71 | Facility | None | $1,122.02 | $1,412.54 | $2,454.71 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $2,818.38 Typical High $5,248.07 | Professional | None | $1,230.27 | $2,818.38 | $5,248.07 |
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 $1,659.59 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,659.59 | $1,659.59 | $3,890.45 |
Security Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Security Health Setting Professional Modifier None Typical Low $5,888.44 Median $7,244.36 Typical High $9,332.54 | Professional | None | $5,888.44 | $7,244.36 | $9,332.54 |
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 $1,174.90 Median $3,388.44 Typical High $6,165.95 | Professional | None | $1,174.90 | $3,388.44 | $6,165.95 |
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 $630.96 Median $630.96 Typical High $5,754.40 | Professional | 52 · Reduced service | $630.96 | $630.96 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $2,344.23 | Professional | 53 · Discontinued | $251.19 | $251.19 | $2,344.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $8,709.64 | Professional | 54 · Surgery only | $954.99 | $954.99 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $1,737.80 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $1,174.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $8,128.31 |
Where Wisconsin sits
The same service costs 5.9 times more in Alaska than in Texas. 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
$4,074
AK $4,898TX $832
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.