How much rates vary
Facilitymedian $15,136 · 10th to 90th $1,349 to $29,512Professionalmedian $2,512 · 10th to 90th $832 to $6,166
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 $831.76 Median $3,090.30 Typical High $14,454.40 | Facility | None | $831.76 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $8,709.64 | Professional | None | $831.76 | $831.76 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $17,782.79 Typical High $23,988.33 | Facility | None | $13,182.57 | $17,782.79 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $2,951.21 Typical High $6,309.57 | Professional | None | $977.24 | $2,951.21 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,862.09 Typical High $3,981.07 | Professional | 62 · Two surgeons | $616.60 | $1,862.09 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $478.63 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $154.88 | $478.63 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $416.87 Typical High $870.96 | Professional | AS · PA/NP assist | $138.04 | $416.87 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $43,651.58 | Facility | None | $1,000.00 | $2,754.23 | $43,651.58 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,659.59 | $2,884.03 |
DeanCare Setting Facility Modifier None Typical Low $870.96 Median $3,162.28 Typical High $5,888.44 | Facility | None | $870.96 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,412.54 | $2,089.30 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $9,120.11 Typical High $19,952.62 | Facility | None | $1,174.90 | $9,120.11 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,511.89 Typical High $5,370.32 | Professional | None | $912.01 | $2,511.89 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Network Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,995.26 | $2,630.27 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,584.89 | Facility | None | $575.44 | $870.96 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,819.70 Typical High $3,388.44 | Professional | None | $794.33 | $1,819.70 | $3,388.44 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $29,512.09 Typical High $47,863.01 | Facility | None | $724.44 | $29,512.09 | $47,863.01 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,071.52 | $2,511.89 |
Security Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $3,801.89 Median $4,677.35 Typical High $6,165.95 | Professional | None | $3,801.89 | $4,677.35 | $6,165.95 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $776.25 Median $2,187.76 Typical High $3,981.07 | Professional | None | $776.25 | $2,187.76 | $3,981.07 |
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 $416.87 Median $416.87 Typical High $4,365.16 | Professional | 52 · Reduced service | $416.87 | $416.87 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $1,737.80 | Professional | 53 · Discontinued | $165.96 | $165.96 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $6,606.93 | Professional | 54 · Surgery only | $616.60 | $616.60 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $1,318.26 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $870.96 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $6,165.95 |
Where Wisconsin sits
The same service costs 6.8 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· 3rd of 51
$3,162
AK $3,715TX $550
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.