How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,318 to $21,380Professionalmedian $2,570 · 10th to 90th $912 to $5,012
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 $912.01 Median $8,511.38 Typical High $14,454.40 | Facility | None | $912.01 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $8,317.64 | Professional | None | $912.01 | $912.01 | $8,317.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $17,782.79 Typical High $26,302.68 | Facility | None | $12,022.64 | $17,782.79 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $5,128.61 | Professional | None | $1,000.00 | $2,884.03 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $467.74 Typical High $812.83 | Professional | 80 · Assistant surgeon | $158.49 | $467.74 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $407.38 Typical High $707.95 | Professional | AS · PA/NP assist | $141.25 | $407.38 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $12,882.50 | Facility | None | $954.99 | $2,754.23 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,659.59 | $2,884.03 |
DeanCare Setting Facility Modifier None Typical Low $870.96 Median $5,128.61 Typical High $9,772.37 | Facility | None | $870.96 | $5,128.61 | $9,772.37 |
DeanCare Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,412.54 | $2,089.30 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $7,585.78 Typical High $16,595.87 | Facility | None | $1,230.27 | $7,585.78 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,630.78 | Professional | None | $933.25 | $1,995.26 | $3,630.78 |
Network Health Setting Facility Modifier None Typical Low $5,128.61 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,128.61 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $2,344.23 | Professional | None | $1,174.90 | $2,290.87 | $2,344.23 |
Prevea360 Setting Facility Modifier None Typical Low $724.44 Median $870.96 Typical High $1,621.81 | Facility | None | $724.44 | $870.96 | $1,621.81 |
Quartz Setting Professional Modifier None Typical Low $794.33 Median $1,819.70 Typical High $3,467.37 | Professional | None | $794.33 | $1,819.70 | $3,467.37 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $8,511.38 Typical High $14,125.38 | Facility | None | $758.58 | $8,511.38 | $14,125.38 |
Quartz Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,202.26 | $2,344.23 |
Security Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Security Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $5,011.87 | Professional | None | $3,630.78 | $4,365.16 | $5,011.87 |
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 $812.83 Median $2,137.96 Typical High $3,715.35 | Professional | None | $812.83 | $2,137.96 | $3,715.35 |
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 $457.09 Median $457.09 Typical High $4,168.69 | Professional | 52 · Reduced service | $457.09 | $457.09 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $1,659.59 | Professional | 53 · Discontinued | $181.97 | $181.97 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $6,165.95 | Professional | 54 · Surgery only | $676.08 | $676.08 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $1,258.93 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $831.76 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $5,754.40 |
Where Wisconsin sits
The same service costs 11.0 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· 3rd of 51
$3,090
OK $5,888UT $537
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.