How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,096 to $11,482Professionalmedian $1,349 · 10th to 90th $490 to $2,399
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 $489.78 Median $8,317.64 Typical High $14,454.40 | Facility | None | $489.78 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $4,466.84 | Professional | None | $489.78 | $489.78 | $4,466.84 |
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 $537.03 Median $1,479.11 Typical High $2,630.27 | Professional | None | $537.03 | $1,479.11 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $2,187.76 Typical High $3,981.07 | Professional | 50 · Both sides | $812.83 | $2,187.76 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $933.25 Typical High $1,659.59 | Professional | 62 · Two surgeons | $338.84 | $933.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $239.88 Typical High $416.87 | Professional | 80 · Assistant surgeon | $85.11 | $239.88 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $204.17 Typical High $371.54 | Professional | AS · PA/NP assist | $74.13 | $204.17 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $8,511.38 | Facility | None | $1,071.52 | $1,905.46 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,584.89 | Professional | None | $588.84 | $954.99 | $1,584.89 |
DeanCare Setting Facility Modifier None Typical Low $501.19 Median $5,128.61 Typical High $9,332.54 | Facility | None | $501.19 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,412.54 | Professional | None | $776.25 | $1,148.15 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $5,623.41 Typical High $14,791.08 | Facility | None | $870.96 | $5,623.41 | $14,791.08 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,348.96 Typical High $2,290.87 | Professional | None | $489.78 | $1,348.96 | $2,290.87 |
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 $630.96 Median $1,096.48 Typical High $1,412.54 | Professional | None | $630.96 | $1,096.48 | $1,412.54 |
Prevea360 Setting Facility Modifier None Typical Low $467.74 Median $537.03 Typical High $933.25 | Facility | None | $467.74 | $537.03 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $436.52 Median $1,023.29 Typical High $1,862.09 | Professional | None | $436.52 | $1,023.29 | $1,862.09 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $5,623.41 Typical High $9,332.54 | Facility | None | $933.25 | $5,623.41 | $9,332.54 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,380.38 | Professional | None | $588.84 | $588.84 | $1,380.38 |
Security Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Security Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,949.84 | $2,187.76 |
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 $407.38 Median $1,174.90 Typical High $2,187.76 | Professional | None | $407.38 | $1,174.90 | $2,187.76 |
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 $245.47 Median $245.47 Typical High $2,238.72 | Professional | 52 · Reduced service | $245.47 | $245.47 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $891.25 | Professional | 53 · Discontinued | $100.00 | $100.00 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $3,388.44 | Professional | 54 · Surgery only | $371.54 | $371.54 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $676.08 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $446.68 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $3,162.28 |
Where Wisconsin sits
The same service costs 9.8 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· 4th of 51
$1,698
OK $3,236UT $331
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.