How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,230 to $12,882Professionalmedian $3,020 · 10th to 90th $1,096 to $5,495
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 $1,096.48 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,096.48 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $10,471.29 | Professional | None | $1,096.48 | $1,096.48 | $10,471.29 |
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 $1,202.26 Median $3,311.31 Typical High $6,165.95 | Professional | None | $1,202.26 | $3,311.31 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $2,089.30 Typical High $3,890.45 | Professional | 62 · Two surgeons | $741.31 | $2,089.30 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $537.03 Typical High $977.24 | Professional | 80 · Assistant surgeon | $190.55 | $537.03 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $467.74 Typical High $851.14 | Professional | AS · PA/NP assist | $165.96 | $467.74 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $4,570.88 | Facility | None | $954.99 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,318.26 | $1,995.26 | $3,630.78 |
DeanCare Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,047.13 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,570.40 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $6,606.93 Typical High $13,182.57 | Facility | None | $1,047.13 | $6,606.93 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $5,128.61 | Professional | None | $1,122.02 | $3,162.28 | $5,128.61 |
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 $1,412.54 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,412.54 | $2,398.83 | $3,162.28 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,949.84 | Facility | None | $933.25 | $1,047.13 | $1,949.84 |
Quartz Setting Professional Modifier None Typical Low $954.99 Median $2,238.72 Typical High $4,168.69 | Professional | None | $954.99 | $2,238.72 | $4,168.69 |
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 $1,318.26 Median $1,318.26 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,318.26 | $3,090.30 |
Security Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,365.16 Typical High $5,011.87 | Professional | None | $2,884.03 | $4,365.16 | $5,011.87 |
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 $954.99 Median $2,754.23 Typical High $4,897.79 | Professional | None | $954.99 | $2,754.23 | $4,897.79 |
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 $549.54 Median $549.54 Typical High $5,248.07 | Professional | 52 · Reduced service | $549.54 | $549.54 | $5,248.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $2,089.30 | Professional | 53 · Discontinued | $218.78 | $218.78 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $7,762.47 | Professional | 54 · Surgery only | $831.76 | $831.76 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $1,548.82 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $7,244.36 |
Where Wisconsin sits
The same service costs 5.9 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
$3,548
OK $4,074UT $692
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.