How much rates vary
Facilitymedian $6,607 · 10th to 90th $891 to $13,183Professionalmedian $977 · 10th to 90th $347 to $1,905
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 $346.74 Median $6,456.54 Typical High $14,454.40 | Facility | None | $346.74 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $5,495.41 | Professional | None | $346.74 | $346.74 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $1,174.90 Typical High $1,995.26 | Professional | None | $380.19 | $1,174.90 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $741.31 Typical High $1,258.93 | Professional | 62 · Two surgeons | $239.88 | $741.31 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $186.21 Typical High $316.23 | Professional | 80 · Assistant surgeon | $60.26 | $186.21 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $162.18 Typical High $275.42 | Professional | AS · PA/NP assist | $53.70 | $162.18 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,479.11 Typical High $5,754.40 | Facility | None | $794.33 | $1,479.11 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,230.27 | Professional | None | $457.09 | $660.69 | $1,230.27 |
DeanCare Setting Facility Modifier None Typical Low $354.81 Median $4,365.16 Typical High $7,762.47 | Facility | None | $354.81 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,023.29 | Professional | None | $537.03 | $794.33 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $12,589.25 | Facility | None | $851.14 | $5,623.41 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $954.99 Typical High $1,819.70 | Professional | None | $371.54 | $954.99 | $1,819.70 |
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 $446.68 Median $891.25 Typical High $1,202.26 | Professional | None | $446.68 | $891.25 | $1,202.26 |
Prevea360 Setting Facility Modifier None Typical Low $331.13 Median $380.19 Typical High $933.25 | Facility | None | $331.13 | $380.19 | $933.25 |
Quartz Setting Professional Modifier None Typical Low $302.00 Median $691.83 Typical High $1,318.26 | Professional | None | $302.00 | $691.83 | $1,318.26 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $6,309.57 | Facility | None | $758.58 | $3,801.89 | $6,309.57 |
Quartz Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $891.25 | Professional | None | $457.09 | $457.09 | $891.25 |
Security Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Security Health Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $1,778.28 | Professional | None | $831.76 | $1,548.82 | $1,778.28 |
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 $331.13 Median $831.76 Typical High $1,445.44 | Professional | None | $331.13 | $831.76 | $1,445.44 |
5 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 $173.78 Median $173.78 Typical High $2,754.23 | Professional | 52 · Reduced service | $173.78 | $173.78 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $1,096.48 | Professional | 53 · Discontinued | $69.18 | $69.18 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $4,168.69 | Professional | 54 · Surgery only | $263.03 | $263.03 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $831.76 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $549.54 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $549.54 |
Where Wisconsin sits
The same service costs 10.0 times more in Oklahoma than in New York. 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
$1,259
OK $2,884NY $288
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.