How much rates vary
Facilitymedian $5,129 · 10th to 90th $832 to $9,120Professionalmedian $1,549 · 10th to 90th $575 to $2,754
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 $575.44 Median $1,905.46 Typical High $14,454.40 | Facility | None | $575.44 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $7,943.28 | Professional | None | $575.44 | $575.44 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,698.24 Typical High $3,019.95 | Professional | None | $616.60 | $1,698.24 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $2,570.40 Typical High $4,570.88 | Professional | 50 · Both sides | $933.25 | $2,570.40 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $1,096.48 Typical High $1,905.46 | Professional | 62 · Two surgeons | $389.05 | $1,096.48 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $281.84 Typical High $489.78 | Professional | 80 · Assistant surgeon | $97.72 | $281.84 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $239.88 Typical High $426.58 | Professional | AS · PA/NP assist | $87.10 | $239.88 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $4,365.16 | Facility | None | $707.95 | $1,737.80 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,862.09 | Professional | None | $676.08 | $1,047.13 | $1,862.09 |
DeanCare Setting Facility Modifier None Typical Low $588.84 Median $2,754.23 Typical High $5,128.61 | Facility | None | $588.84 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,659.59 | Professional | None | $891.25 | $1,318.26 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $3,388.44 Typical High $8,912.51 | Facility | None | $812.83 | $3,388.44 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,584.89 Typical High $2,630.27 | Professional | None | $575.44 | $1,584.89 | $2,630.27 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $741.31 Median $1,258.93 Typical High $1,659.59 | Professional | None | $741.31 | $1,258.93 | $1,659.59 |
Prevea360 Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $1,000.00 | Facility | None | $537.03 | $676.08 | $1,000.00 |
Quartz Setting Professional Modifier None Typical Low $501.19 Median $1,174.90 Typical High $2,137.96 | Professional | None | $501.19 | $1,174.90 | $2,137.96 |
Quartz Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $4,786.30 | Facility | None | $537.03 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,584.89 | Professional | None | $676.08 | $676.08 | $1,584.89 |
Security Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,570.40 | Professional | None | $1,479.11 | $2,238.72 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $489.78 Median $1,412.54 Typical High $2,511.89 | Professional | None | $489.78 | $1,412.54 | $2,511.89 |
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 $288.40 Median $288.40 Typical High $3,981.07 | Professional | 52 · Reduced service | $288.40 | $288.40 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $1,584.89 | Professional | 53 · Discontinued | $114.82 | $114.82 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $6,025.60 | Professional | 54 · Surgery only | $426.58 | $426.58 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $1,202.26 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $794.33 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $5,623.41 |
Where Wisconsin sits
The same service costs 5.5 times more in Alaska 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· 2nd of 51
$1,905
AK $2,042UT $372
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.