How much rates vary
Facilitymedian $4,266 · 10th to 90th $977 to $8,710Professionalmedian $1,288 · 10th to 90th $479 to $2,512
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 $478.63 Median $6,456.54 Typical High $14,454.40 | Facility | None | $478.63 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $4,073.80 | Professional | None | $446.68 | $478.63 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $8,709.64 | Facility | None | $2,818.38 | $4,786.30 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,445.44 Typical High $2,630.27 | Professional | None | $537.03 | $1,445.44 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $912.01 Typical High $1,659.59 | Professional | 62 · Two surgeons | $338.84 | $912.01 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $234.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $85.11 | $234.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $204.17 Typical High $371.54 | Professional | AS · PA/NP assist | $74.13 | $204.17 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $4,365.16 | Facility | None | $977.24 | $1,862.09 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,479.11 | Professional | None | $575.44 | $933.25 | $1,479.11 |
DeanCare Setting Facility Modifier None Typical Low $467.74 Median $7,943.28 Typical High $14,454.40 | Facility | None | $467.74 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,288.25 | Professional | None | $758.58 | $1,122.02 | $1,288.25 |
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 $467.74 Median $1,202.26 Typical High $2,041.74 | Professional | None | $467.74 | $1,202.26 | $2,041.74 |
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 $616.60 Median $1,071.52 Typical High $1,258.93 | Professional | None | $616.60 | $1,071.52 | $1,258.93 |
Prevea360 Setting Facility Modifier None Typical Low $389.05 Median $489.78 Typical High $851.14 | Facility | None | $389.05 | $489.78 | $851.14 |
Quartz Setting Professional Modifier None Typical Low $426.58 Median $977.24 Typical High $1,819.70 | Professional | None | $426.58 | $977.24 | $1,819.70 |
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 $630.96 Median $630.96 Typical High $1,230.27 | Professional | None | $630.96 | $630.96 | $1,230.27 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Security Health Setting Professional Modifier None Typical Low $1,047.13 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,047.13 | $2,137.96 | $2,398.83 |
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 $380.19 Median $1,071.52 Typical High $1,819.70 | Professional | None | $380.19 | $1,071.52 | $1,819.70 |
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 $239.88 Median $239.88 Typical High $2,041.74 | Professional | 52 · Reduced service | $239.88 | $239.88 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $812.83 | Professional | 53 · Discontinued | $97.72 | $97.72 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $3,019.95 | Professional | 54 · Surgery only | $363.08 | $363.08 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $602.56 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $407.38 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $2,818.38 |
Where Wisconsin sits
The same service costs 10.2 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
$1,622
OK $2,951UT $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.