How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,514 to $20,417Professionalmedian $3,467 · 10th to 90th $1,259 to $6,761
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 $1,258.93 Median $11,220.18 Typical High $14,454.40 | Facility | None | $1,258.93 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $9,549.93 | Professional | None | $1,258.93 | $1,258.93 | $9,549.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,220.18 Median $15,848.93 Typical High $23,988.33 | Facility | None | $11,220.18 | $15,848.93 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $4,168.69 Typical High $7,079.46 | Professional | None | $1,380.38 | $4,168.69 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $2,511.89 Typical High $4,466.84 | Professional | 62 · Two surgeons | $870.96 | $2,511.89 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $660.69 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $218.78 | $660.69 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $575.44 Typical High $977.24 | Professional | AS · PA/NP assist | $190.55 | $575.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,801.89 Typical High $12,882.50 | Facility | None | $1,348.96 | $3,801.89 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,548.82 | $2,290.87 | $4,265.80 |
DeanCare Setting Facility Modifier None Typical Low $1,202.26 Median $8,128.31 Typical High $14,791.08 | Facility | None | $1,202.26 | $8,128.31 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $3,630.78 | Professional | None | $1,949.84 | $2,884.03 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $8,317.64 Typical High $16,595.87 | Facility | None | $1,258.93 | $8,317.64 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $3,235.94 Typical High $5,248.07 | Professional | None | $1,288.25 | $3,235.94 | $5,248.07 |
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 $1,584.89 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,754.23 | $3,548.13 |
Prevea360 Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,238.72 | Facility | None | $1,000.00 | $1,288.25 | $2,238.72 |
Quartz Setting Professional Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $4,677.35 | Professional | None | $1,096.48 | $2,511.89 | $4,677.35 |
Quartz Setting Facility Modifier None Typical Low $1,071.52 Median $8,511.38 Typical High $14,125.38 | Facility | None | $1,071.52 | $8,511.38 | $14,125.38 |
Quartz Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,659.59 | $1,659.59 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Security Health Setting Professional Modifier None Typical Low $2,951.21 Median $5,623.41 Typical High $6,309.57 | Professional | None | $2,951.21 | $5,623.41 | $6,309.57 |
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 $1,071.52 Median $2,951.21 Typical High $5,128.61 | Professional | None | $1,071.52 | $2,951.21 | $5,128.61 |
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 $630.96 Median $630.96 Typical High $4,786.30 | Professional | 52 · Reduced service | $630.96 | $630.96 | $4,786.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $1,905.46 | Professional | 53 · Discontinued | $251.19 | $251.19 | $1,905.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $7,244.36 | Professional | 54 · Surgery only | $933.25 | $933.25 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $1,445.44 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $954.99 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $954.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $6,760.83 |
Where Wisconsin sits
The same service costs 8.7 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
$4,169
OK $6,166TX $708
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.