How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,175 to $19,953Professionalmedian $2,344 · 10th to 90th $871 to $4,677
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 $870.96 Median $870.96 Typical High $14,454.40 | Facility | None | $870.96 | $870.96 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $6,606.93 | Professional | None | $870.96 | $870.96 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $15,848.93 Typical High $23,988.33 | Facility | None | $8,709.64 | $15,848.93 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $2,691.53 Typical High $4,786.30 | Professional | None | $954.99 | $2,691.53 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $1,698.24 Typical High $3,019.95 | Professional | 62 · Two surgeons | $602.56 | $1,698.24 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $426.58 Typical High $758.58 | Professional | 80 · Assistant surgeon | $151.36 | $426.58 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $371.54 Typical High $676.08 | Professional | AS · PA/NP assist | $131.83 | $371.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $8,128.31 | Facility | None | $1,023.29 | $2,691.53 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,621.81 | $2,691.53 |
DeanCare Setting Facility Modifier None Typical Low $831.76 Median $4,365.16 Typical High $7,762.47 | Facility | None | $831.76 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,380.38 | $2,041.74 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $4,570.88 Typical High $12,589.25 | Facility | None | $912.01 | $4,570.88 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $2,238.72 Typical High $3,630.78 | Professional | None | $870.96 | $2,238.72 | $3,630.78 |
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 $1,122.02 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,949.84 | $2,290.87 |
Prevea360 Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $1,548.82 | Facility | None | $707.95 | $891.25 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $3,311.31 | Professional | None | $758.58 | $1,737.80 | $3,311.31 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $5,370.32 Typical High $8,912.51 | Facility | None | $812.83 | $5,370.32 | $8,912.51 |
Quartz Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,148.15 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $4,365.16 | Professional | None | $1,995.26 | $3,801.89 | $4,365.16 |
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 $724.44 Median $2,041.74 Typical High $3,467.37 | Professional | None | $724.44 | $2,041.74 | $3,467.37 |
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 $436.52 Median $436.52 Typical High $3,311.31 | Professional | 52 · Reduced service | $436.52 | $436.52 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $1,318.26 | Professional | 53 · Discontinued | $173.78 | $173.78 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $5,011.87 | Professional | 54 · Surgery only | $660.69 | $660.69 | $5,011.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $1,000.00 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $660.69 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $4,677.35 |
Where Wisconsin sits
The same service costs 6.8 times more in Oklahoma 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· 3rd of 51
$2,818
OK $3,548TX $525
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.