How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,175 to $14,454Professionalmedian $2,239 · 10th to 90th $813 to $4,074
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 $812.83 Median $6,456.54 Typical High $14,454.40 | Facility | None | $812.83 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $5,888.44 | Professional | None | $812.83 | $812.83 | $5,888.44 |
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 $891.25 Median $2,454.71 Typical High $4,570.88 | Professional | None | $891.25 | $2,454.71 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $1,548.82 Typical High $2,884.03 | Professional | 62 · Two surgeons | $562.34 | $1,548.82 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $398.11 Typical High $724.44 | Professional | 80 · Assistant surgeon | $141.25 | $398.11 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $354.81 Typical High $630.96 | Professional | AS · PA/NP assist | $123.03 | $354.81 | $630.96 |
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 $977.24 Median $1,513.56 Typical High $2,630.27 | Professional | None | $977.24 | $1,513.56 | $2,630.27 |
DeanCare Setting Facility Modifier None Typical Low $831.76 Median $7,943.28 Typical High $14,454.40 | Facility | None | $831.76 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,905.46 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $14,454.40 | Facility | None | $954.99 | $6,606.93 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,801.89 | Professional | None | $812.83 | $2,290.87 | $3,801.89 |
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 $1,047.13 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,778.28 | $2,344.23 |
Prevea360 Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,445.44 | Facility | None | $776.25 | $933.25 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $724.44 Median $1,659.59 Typical High $3,090.30 | Professional | None | $724.44 | $1,659.59 | $3,090.30 |
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 $977.24 Median $977.24 Typical High $2,290.87 | Professional | None | $977.24 | $977.24 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $3,630.78 | Professional | None | $2,137.96 | $3,235.94 | $3,630.78 |
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 $660.69 Median $2,041.74 Typical High $3,630.78 | Professional | None | $660.69 | $2,041.74 | $3,630.78 |
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 $407.38 Median $407.38 Typical High $2,951.21 | Professional | 52 · Reduced service | $407.38 | $407.38 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $1,174.90 | Professional | 53 · Discontinued | $162.18 | $162.18 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $4,466.84 | Professional | 54 · Surgery only | $616.60 | $616.60 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $891.25 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $588.84 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $4,168.69 |
Where Wisconsin sits
The same service costs 8.7 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 $4,365UT $501
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.