How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,148 to $13,804Professionalmedian $2,818 · 10th to 90th $912 to $6,457
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 $3,090.30 Typical High $14,454.40 | Facility | None | $912.01 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $8,317.64 | Professional | None | $912.01 | $912.01 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
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 $1,096.48 | Professional | 80 · Assistant surgeon | $173.78 | $524.81 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $457.09 Typical High $954.99 | Professional | AS · PA/NP assist | $151.36 | $457.09 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,019.95 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,819.70 | $3,162.28 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $5,888.44 | Facility | None | $954.99 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,290.87 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $5,623.41 Typical High $13,803.84 | Facility | None | $1,023.29 | $5,623.41 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $5,888.44 | Professional | None | $1,023.29 | $2,754.23 | $5,888.44 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,258.93 | $2,187.76 | $2,884.03 |
Prevea360 Setting Facility Modifier None Typical Low $870.96 Median $954.99 Typical High $1,737.80 | Facility | None | $870.96 | $954.99 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $870.96 Median $1,995.26 Typical High $3,715.35 | Professional | None | $870.96 | $1,995.26 | $3,715.35 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $4,570.88 Typical High $7,585.78 | Facility | None | $724.44 | $4,570.88 | $7,585.78 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
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 $4,168.69 Median $5,128.61 Typical High $6,760.83 | Professional | None | $4,168.69 | $5,128.61 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
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 $4,168.69 | Professional | 52 · Reduced service | $457.09 | $457.09 | $4,168.69 |
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 $676.08 Median $676.08 Typical High $6,309.57 | Professional | 54 · Surgery only | $676.08 | $676.08 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $1,258.93 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $831.76 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $5,888.44 |
Where Wisconsin sits
The same service costs 5.6 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· 3rd of 51
$3,311
AK $3,548UT $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.