How much rates vary
Facilitymedian $5,129 · 10th to 90th $794 to $16,218Professionalmedian $2,818 · 10th to 90th $912 to $6,607
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 $912.01 Median $912.01 Typical High $14,454.40 | Facility | None | $912.01 | $912.01 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $8,511.38 | Professional | None | $912.01 | $912.01 | $8,511.38 |
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 $1,071.52 Median $3,311.31 Typical High $6,918.31 | Professional | None | $1,071.52 | $3,311.31 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $2,089.30 Typical High $4,365.16 | Professional | 62 · Two surgeons | $676.08 | $2,089.30 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $524.81 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $173.78 | $524.81 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $467.74 Typical High $977.24 | Professional | AS · PA/NP assist | $151.36 | $467.74 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,630.78 | Facility | None | $812.83 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,819.70 | $3,162.28 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $7,943.28 Typical High $14,454.40 | Facility | None | $954.99 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,344.23 | $2,884.03 |
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 $2,818.38 Typical High $5,888.44 | Professional | None | $1,023.29 | $2,818.38 | $5,888.44 |
Network Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,089.30 | Facility | None | $1,288.25 | $1,737.80 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,288.25 | $2,187.76 | $2,884.03 |
Prevea360 Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,778.28 | Facility | None | $794.33 | $1,023.29 | $1,778.28 |
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 $1,202.26 Median $1,202.26 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,202.26 | $2,818.38 |
Security Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $5,128.61 Typical High $6,760.83 | Professional | None | $4,265.80 | $5,128.61 | $6,760.83 |
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 $2,454.71 Typical High $4,365.16 | Professional | None | $851.14 | $2,454.71 | $4,365.16 |
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 $457.09 Median $457.09 Typical High $4,265.80 | Professional | 52 · Reduced service | $457.09 | $457.09 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $1,698.24 | Professional | 53 · Discontinued | $181.97 | $181.97 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $6,309.57 | Professional | 54 · Surgery only | $691.83 | $691.83 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $1,258.93 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $851.14 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $5,888.44 |
Where Wisconsin sits
The same service costs 5.6 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
$3,090
AK $3,548TX $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.