How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,000 to $13,183Professionalmedian $2,042 · 10th to 90th $661 to $4,898
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 $660.69 Median $6,456.54 Typical High $14,454.40 | Facility | None | $660.69 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $6,165.95 | Professional | None | $660.69 | $660.69 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $9,332.54 Typical High $16,982.44 | Facility | None | $5,754.40 | $9,332.54 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $2,398.83 Typical High $5,011.87 | Professional | None | $776.25 | $2,398.83 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $1,513.56 Typical High $3,162.28 | Professional | 62 · Two surgeons | $489.78 | $1,513.56 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $380.19 Typical High $794.33 | Professional | 80 · Assistant surgeon | $125.89 | $380.19 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $331.13 Typical High $707.95 | Professional | AS · PA/NP assist | $109.65 | $331.13 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,691.53 Typical High $6,918.31 | Facility | None | $954.99 | $2,691.53 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $2,290.87 | Professional | None | $870.96 | $1,318.26 | $2,290.87 |
DeanCare Setting Facility Modifier None Typical Low $741.31 Median $4,365.16 Typical High $7,762.47 | Facility | None | $741.31 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,698.24 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $3,388.44 Typical High $9,549.93 | Facility | None | $812.83 | $3,388.44 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,995.26 Typical High $4,265.80 | Professional | None | $741.31 | $1,995.26 | $4,265.80 |
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 $933.25 Median $1,584.89 Typical High $2,089.30 | Professional | None | $933.25 | $1,584.89 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $1,288.25 | Facility | None | $645.65 | $812.83 | $1,288.25 |
Quartz Setting Professional Modifier None Typical Low $645.65 Median $1,479.11 Typical High $2,691.53 | Professional | None | $645.65 | $1,479.11 | $2,691.53 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $4,570.88 Typical High $7,585.78 | Facility | None | $758.58 | $4,570.88 | $7,585.78 |
Quartz Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,995.26 | Professional | None | $870.96 | $870.96 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,715.35 Typical High $4,897.79 | Professional | None | $3,019.95 | $3,715.35 | $4,897.79 |
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 $616.60 Median $1,778.28 Typical High $3,162.28 | Professional | None | $616.60 | $1,778.28 | $3,162.28 |
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 $331.13 Median $331.13 Typical High $3,090.30 | Professional | 52 · Reduced service | $331.13 | $331.13 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,230.27 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $4,570.88 | Professional | 54 · Surgery only | $501.19 | $501.19 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $912.01 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $616.60 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $4,265.80 |
Where Wisconsin sits
The same service costs 5.4 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
$2,512
AK $2,570UT $479
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.