How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,175 to $11,220Professionalmedian $2,239 · 10th to 90th $813 to $3,981
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 $5,754.40 | Professional | None | $812.83 | $812.83 | $5,754.40 |
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 $870.96 Median $2,511.89 Typical High $4,466.84 | Professional | None | $870.96 | $2,511.89 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $1,584.89 Typical High $2,818.38 | Professional | 62 · Two surgeons | $549.54 | $1,584.89 | $2,818.38 |
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 $346.74 Typical High $630.96 | Professional | AS · PA/NP assist | $123.03 | $346.74 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,511.89 Typical High $4,365.16 | Facility | None | $954.99 | $2,511.89 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,630.27 | Professional | None | $977.24 | $1,479.11 | $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 $1,258.93 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,905.46 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $933.25 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $2,290.87 Typical High $3,715.35 | Professional | None | $794.33 | $2,290.87 | $3,715.35 |
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 $1,047.13 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 $758.58 Median $933.25 Typical High $1,445.44 | Facility | None | $758.58 | $933.25 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $724.44 Median $1,659.59 Typical High $3,019.95 | Professional | None | $724.44 | $1,659.59 | $3,019.95 |
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 $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 $1,318.26 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 $660.69 Median $1,995.26 Typical High $3,630.78 | Professional | None | $660.69 | $1,995.26 | $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 $2,884.03 | Professional | 52 · Reduced service | $407.38 | $407.38 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $1,148.15 | Professional | 53 · Discontinued | $162.18 | $162.18 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $4,365.16 | Professional | 54 · Surgery only | $616.60 | $616.60 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $870.96 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $575.44 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $4,073.80 |
Where Wisconsin sits
The same service costs 7.2 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
$2,692
OK $3,802UT $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.