How much rates vary
Facilitymedian $3,631 · 10th to 90th $813 to $7,943Professionalmedian $871 · 10th to 90th $324 to $1,660
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 $323.59 Median $1,905.46 Typical High $14,454.40 | Facility | None | $323.59 | $1,905.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $2,187.76 | Professional | None | $323.59 | $323.59 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $1,000.00 Typical High $1,737.80 | Professional | None | $346.74 | $1,000.00 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $1,513.56 Typical High $2,570.40 | Professional | 50 · Both sides | $524.81 | $1,513.56 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $630.96 Typical High $1,096.48 | Professional | 62 · Two surgeons | $218.78 | $630.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $158.49 Typical High $275.42 | Professional | 80 · Assistant surgeon | $56.23 | $158.49 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $141.25 Typical High $239.88 | Professional | AS · PA/NP assist | $48.98 | $141.25 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $4,365.16 | Facility | None | $741.31 | $1,479.11 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $1,071.52 | Professional | None | $398.11 | $616.60 | $1,071.52 |
DeanCare Setting Facility Modifier None Typical Low $309.03 Median $2,818.38 Typical High $5,128.61 | Facility | None | $309.03 | $2,818.38 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $891.25 | Professional | None | $512.86 | $758.58 | $891.25 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $8,317.64 | Facility | None | $691.83 | $3,162.28 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $812.83 Typical High $1,380.38 | Professional | None | $323.59 | $812.83 | $1,380.38 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $870.96 | Professional | None | $416.87 | $707.95 | $870.96 |
Prevea360 Setting Facility Modifier None Typical Low $263.03 Median $331.13 Typical High $575.44 | Facility | None | $263.03 | $331.13 | $575.44 |
Quartz Setting Professional Modifier None Typical Low $281.84 Median $645.65 Typical High $1,230.27 | Professional | None | $281.84 | $645.65 | $1,230.27 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $2,884.03 Typical High $4,786.30 | Facility | None | $812.83 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $831.76 | Professional | None | $426.58 | $426.58 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Security Health Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $1,621.81 | Professional | None | $724.44 | $1,445.44 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $257.04 Median $741.31 Typical High $1,258.93 | Professional | None | $257.04 | $741.31 | $1,258.93 |
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 $162.18 Median $162.18 Typical High $1,096.48 | Professional | 52 · Reduced service | $162.18 | $162.18 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $436.52 | Professional | 53 · Discontinued | $64.57 | $64.57 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $1,621.81 | Professional | 54 · Surgery only | $245.47 | $245.47 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $323.59 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $218.78 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $1,513.56 |
Where Wisconsin sits
The same service costs 6.0 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· 5th of 51
$1,096
OK $1,479UT $245
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.