How much rates vary
Facilitymedian $6,918 · 10th to 90th $912 to $18,197Professionalmedian $4,266 · 10th to 90th $1,585 to $8,710
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 $1,584.89 Median $1,584.89 Typical High $14,454.40 | Facility | None | $1,584.89 | $1,584.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $15,488.17 | Professional | None | $1,584.89 | $1,584.89 | $15,488.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $12,022.64 Typical High $19,498.45 | Facility | None | $5,888.44 | $12,022.64 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $5,011.87 Typical High $8,709.64 | Professional | None | $1,737.80 | $5,011.87 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $3,162.28 Typical High $5,495.41 | Professional | 62 · Two surgeons | $1,096.48 | $3,162.28 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $812.83 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $281.84 | $812.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $707.95 Typical High $1,230.27 | Professional | AS · PA/NP assist | $245.47 | $707.95 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $5,623.41 | Facility | None | $812.83 | $3,630.78 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,951.21 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $1,548.82 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,548.82 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $4,677.35 | Professional | None | $2,511.89 | $3,715.35 | $4,677.35 |
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 $1,513.56 Median $4,073.80 Typical High $6,606.93 | Professional | None | $1,513.56 | $4,073.80 | $6,606.93 |
Network Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $2,630.27 | Facility | None | $2,041.74 | $2,089.30 | $2,630.27 |
Network Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,548.13 Typical High $4,073.80 | Professional | None | $2,041.74 | $3,548.13 | $4,073.80 |
Prevea360 Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,951.21 | Facility | None | $1,288.25 | $1,659.59 | $2,951.21 |
Quartz Setting Professional Modifier None Typical Low $1,479.11 Median $3,388.44 Typical High $6,025.60 | Professional | None | $1,479.11 | $3,388.44 | $6,025.60 |
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 $2,137.96 Median $2,137.96 Typical High $4,073.80 | Professional | None | $2,137.96 | $2,137.96 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Security Health Setting Professional Modifier None Typical Low $3,630.78 Median $7,079.46 Typical High $7,943.28 | Professional | None | $3,630.78 | $7,079.46 | $7,943.28 |
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 $1,318.26 Median $3,630.78 Typical High $6,309.57 | Professional | None | $1,318.26 | $3,630.78 | $6,309.57 |
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 $794.33 Median $794.33 Typical High $7,762.47 | Professional | 52 · Reduced service | $794.33 | $794.33 | $7,762.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $3,162.28 | Professional | 53 · Discontinued | $323.59 | $323.59 | $3,162.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $11,748.98 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $11,748.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $2,344.23 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $2,344.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $1,548.82 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $1,548.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $10,964.78 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $10,964.78 |
Where Wisconsin sits
The same service costs 7.1 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
$4,571
AK $5,754TX $813
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.