How much rates vary
Facilitymedian $6,607 · 10th to 90th $813 to $17,783Professionalmedian $5,012 · 10th to 90th $1,820 to $9,333
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $12,882.50 | Professional | None | $1,819.70 | $1,819.70 | $12,882.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,715.19 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $5,495.41 Typical High $10,232.93 | Professional | None | $1,949.84 | $5,495.41 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $3,467.37 Typical High $6,456.54 | Professional | 62 · Two surgeons | $1,230.27 | $3,467.37 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $891.25 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $316.23 | $891.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $776.25 Typical High $1,445.44 | Professional | AS · PA/NP assist | $275.42 | $776.25 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $6,309.57 | Facility | None | $812.83 | $4,168.69 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,754.40 | Professional | None | $2,137.96 | $3,311.31 | $5,754.40 |
DeanCare Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,737.80 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $5,370.32 | Professional | None | $2,818.38 | $4,168.69 | $5,370.32 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $5,128.61 Typical High $8,511.38 | Professional | None | $1,862.09 | $5,128.61 | $8,511.38 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,162.28 | Facility | None | $2,089.30 | $2,344.23 | $3,162.28 |
Network Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,981.07 Typical High $5,248.07 | Professional | None | $2,344.23 | $3,981.07 | $5,248.07 |
Prevea360 Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,235.94 | Facility | None | $1,445.44 | $1,862.09 | $3,235.94 |
Quartz Setting Professional Modifier None Typical Low $1,584.89 Median $3,630.78 Typical High $6,760.83 | Professional | None | $1,584.89 | $3,630.78 | $6,760.83 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $5,128.61 | Professional | None | $2,187.76 | $2,187.76 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Security Health Setting Professional Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $8,128.31 | Professional | None | $4,786.30 | $7,244.36 | $8,128.31 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $8,128.31 | Professional | None | $1,548.82 | $4,466.84 | $8,128.31 |
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 $912.01 Median $912.01 Typical High $6,456.54 | Professional | 52 · Reduced service | $912.01 | $912.01 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $2,630.27 | Professional | 53 · Discontinued | $363.08 | $363.08 | $2,630.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $9,772.37 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $9,772.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $1,949.84 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $1,949.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $9,120.11 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $9,120.11 |
Where Wisconsin sits
The same service costs 5.9 times more in Alaska than in Texas. 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
$5,129
AK $6,457TX $1,096
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.