How much rates vary
Facilitymedian $3,715 · 10th to 90th $871 to $8,128Professionalmedian $933 · 10th to 90th $309 to $2,239
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 $309.03 Median $8,317.64 Typical High $14,454.40 | Facility | None | $309.03 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $3,630.78 | Professional | None | $309.03 | $309.03 | $3,630.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $1,096.48 Typical High $2,290.87 | Professional | None | $363.08 | $1,096.48 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $691.83 Typical High $1,445.44 | Professional | 62 · Two surgeons | $229.09 | $691.83 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $173.78 Typical High $363.08 | Professional | 80 · Assistant surgeon | $57.54 | $173.78 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $154.88 Typical High $323.59 | Professional | AS · PA/NP assist | $50.12 | $154.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $2,754.23 | Facility | None | $776.25 | $1,445.44 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,071.52 | Professional | None | $398.11 | $645.65 | $1,071.52 |
DeanCare Setting Facility Modifier None Typical Low $346.74 Median $5,128.61 Typical High $9,332.54 | Facility | None | $346.74 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $954.99 | Professional | None | $524.81 | $776.25 | $954.99 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,388.44 Typical High $8,317.64 | Facility | None | $724.44 | $3,388.44 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $912.01 Typical High $1,949.84 | Professional | None | $331.13 | $912.01 | $1,949.84 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $426.58 Median $741.31 Typical High $954.99 | Professional | None | $426.58 | $741.31 | $954.99 |
Prevea360 Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $933.25 | Facility | None | $295.12 | $389.05 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $691.83 Typical High $1,258.93 | Professional | None | $302.00 | $691.83 | $1,258.93 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $3,090.30 | Facility | None | $933.25 | $1,819.70 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $912.01 | Professional | None | $398.11 | $398.11 | $912.01 |
Security Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Security Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,737.80 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $281.84 Median $812.83 Typical High $1,479.11 | Professional | None | $281.84 | $812.83 | $1,479.11 |
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 $154.88 Median $154.88 Typical High $1,819.70 | Professional | 52 · Reduced service | $154.88 | $154.88 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $724.44 | Professional | 53 · Discontinued | $61.66 | $61.66 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $2,754.23 | Professional | 54 · Surgery only | $229.09 | $229.09 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $549.54 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $363.08 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $2,570.40 |
Where Wisconsin sits
The same service costs 6.6 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $6,126MT $925
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.