How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,175 to $12,882Professionalmedian $2,344 · 10th to 90th $851 to $4,266
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 $851.14 Median $6,456.54 Typical High $14,454.40 | Facility | None | $851.14 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $7,943.28 | Professional | None | $851.14 | $851.14 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $2,570.40 Typical High $4,786.30 | Professional | None | $912.01 | $2,570.40 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $416.87 Typical High $758.58 | Professional | 80 · Assistant surgeon | $147.91 | $416.87 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $363.08 Typical High $660.69 | Professional | AS · PA/NP assist | $128.82 | $363.08 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,570.40 Typical High $4,365.16 | Facility | None | $954.99 | $2,570.40 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,548.82 | $2,818.38 |
DeanCare Setting Facility Modifier None Typical Low $870.96 Median $7,943.28 Typical High $14,454.40 | Facility | None | $870.96 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,995.26 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $13,182.57 | Facility | None | $954.99 | $6,606.93 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,454.71 Typical High $3,981.07 | Professional | None | $870.96 | $2,454.71 | $3,981.07 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,862.09 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $933.25 Typical High $1,513.56 | Facility | None | $812.83 | $933.25 | $1,513.56 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $1,737.80 Typical High $3,162.28 | Professional | None | $741.31 | $1,737.80 | $3,162.28 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $4,786.30 | Facility | None | $758.58 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,023.29 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,238.72 | $3,388.44 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $741.31 Median $2,137.96 Typical High $3,801.89 | Professional | None | $741.31 | $2,137.96 | $3,801.89 |
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 $426.58 Median $426.58 Typical High $3,981.07 | Professional | 52 · Reduced service | $426.58 | $426.58 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $1,584.89 | Professional | 53 · Discontinued | $169.82 | $169.82 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $6,025.60 | Professional | 54 · Surgery only | $645.65 | $645.65 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $1,202.26 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $794.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $5,623.41 |
Where Wisconsin sits
The same service costs 7.9 times more in Oklahoma 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
$2,818
OK $4,169UT $525
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.