How much rates vary
Facilitymedian $9,550 · 10th to 90th $1,259 to $16,218Professionalmedian $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 $9,549.93 Typical High $14,454.40 | Facility | None | $489.78 | $9,549.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $3,801.89 | Professional | None | $489.78 | $489.78 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
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 $794.33 Median $2,187.76 Typical High $3,890.45 | Professional | 50 · Both sides | $794.33 | $2,187.76 | $3,890.45 |
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 $363.08 | Professional | AS · PA/NP assist | $74.13 | $204.17 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,019.95 Typical High $7,585.78 | Facility | None | $1,122.02 | $3,019.95 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,548.82 | Professional | None | $588.84 | $933.25 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $501.19 Median $7,943.28 Typical High $14,791.08 | Facility | None | $501.19 | $7,943.28 | $14,791.08 |
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 $933.25 Median $7,943.28 Typical High $16,218.10 | Facility | None | $933.25 | $7,943.28 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,318.26 Typical High $2,290.87 | Professional | None | $489.78 | $1,318.26 | $2,290.87 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
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 $1,000.00 Typical High $1,862.09 | Professional | None | $436.52 | $1,000.00 | $1,862.09 |
Quartz Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $8,317.64 | Facility | None | $1,995.26 | $5,495.41 | $8,317.64 |
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 $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
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 $1,905.46 | Professional | 52 · Reduced service | $245.47 | $245.47 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $758.58 | Professional | 53 · Discontinued | $97.72 | $97.72 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $2,884.03 | Professional | 54 · Surgery only | $371.54 | $371.54 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $575.44 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $380.19 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $2,691.53 |
Where Wisconsin sits
The same service costs 9.5 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· 7th of 51
$1,738
OK $3,236UT $339
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.