How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,096 to $14,454Professionalmedian $2,138 · 10th to 90th $794 to $4,169
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 $794.33 Median $6,456.54 Typical High $14,454.40 | Facility | None | $794.33 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $7,585.78 | Professional | None | $794.33 | $794.33 | $7,585.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,606.93 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $2,511.89 Typical High $4,365.16 | Professional | None | $891.25 | $2,511.89 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $3,715.35 Typical High $6,456.54 | Professional | 50 · Both sides | $1,318.26 | $3,715.35 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $1,584.89 Typical High $2,754.23 | Professional | 62 · Two surgeons | $562.34 | $1,584.89 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $398.11 Typical High $707.95 | Professional | 80 · Assistant surgeon | $141.25 | $398.11 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $346.74 Typical High $616.60 | Professional | AS · PA/NP assist | $123.03 | $346.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $3,090.30 | Facility | None | $812.83 | $1,819.70 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,454.71 | Professional | None | $977.24 | $1,479.11 | $2,454.71 |
DeanCare Setting Facility Modifier None Typical Low $776.25 Median $7,943.28 Typical High $14,454.40 | Facility | None | $776.25 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,862.09 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $4,073.80 Typical High $10,964.78 | Facility | None | $851.14 | $4,073.80 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $2,041.74 Typical High $3,388.44 | Professional | None | $812.83 | $2,041.74 | $3,388.44 |
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 $1,023.29 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,778.28 | $2,290.87 |
Prevea360 Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,412.54 | Facility | None | $645.65 | $831.76 | $1,412.54 |
Quartz Setting Professional Modifier None Typical Low $707.95 Median $1,621.81 Typical High $3,019.95 | Professional | None | $707.95 | $1,621.81 | $3,019.95 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,071.52 | $2,041.74 |
Security Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Security Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,073.80 | Professional | None | $1,819.70 | $3,548.13 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,309.57 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,309.57 | $11,481.54 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,862.09 Typical High $3,162.28 | Professional | None | $630.96 | $1,862.09 | $3,162.28 |
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 $398.11 Median $398.11 Typical High $3,801.89 | Professional | 52 · Reduced service | $398.11 | $398.11 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $1,513.56 | Professional | 53 · Discontinued | $162.18 | $162.18 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $5,754.40 | Professional | 54 · Surgery only | $602.56 | $602.56 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $1,148.15 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $758.58 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $5,370.32 |
Where Wisconsin sits
The same service costs 6.9 times more in Alaska 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· 2nd of 51
$2,570
AK $2,884TX $417
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.