How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,148 to $14,454Professionalmedian $2,188 · 10th to 90th $912 to $3,311
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 $8,317.64 Typical High $14,454.40 | Facility | None | $912.01 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $8,128.31 | Professional | None | $912.01 | $912.01 | $8,128.31 |
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 $954.99 Median $2,398.83 Typical High $3,235.94 | Professional | None | $954.99 | $2,398.83 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $1,479.11 Typical High $2,041.74 | Professional | 62 · Two surgeons | $602.56 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $380.19 Typical High $524.81 | Professional | 80 · Assistant surgeon | $154.88 | $380.19 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $331.13 Typical High $457.09 | Professional | AS · PA/NP assist | $134.90 | $331.13 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $3,388.44 | Facility | None | $812.83 | $1,995.26 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,621.81 | $2,691.53 |
DeanCare Setting Facility Modifier None Typical Low $891.25 Median $7,943.28 Typical High $14,454.40 | Facility | None | $891.25 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,380.38 | $2,041.74 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $4,073.80 Typical High $10,964.78 | Facility | None | $912.01 | $4,073.80 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,187.76 Typical High $3,715.35 | Professional | None | $912.01 | $2,187.76 | $3,715.35 |
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 $1,122.02 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,949.84 | $2,454.71 |
Prevea360 Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $1,659.59 | Facility | None | $707.95 | $933.25 | $1,659.59 |
Quartz Setting Professional Modifier None Typical Low $812.83 Median $1,737.80 Typical High $3,311.31 | Professional | None | $812.83 | $1,737.80 | $3,311.31 |
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 $1,096.48 Median $1,096.48 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,096.48 | $2,187.76 |
Security Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Security Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Professional | None | $1,513.56 | $2,344.23 | $2,630.27 |
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 $741.31 Median $1,995.26 Typical High $3,548.13 | Professional | None | $741.31 | $1,995.26 | $3,548.13 |
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 $4,073.80 | Professional | 52 · Reduced service | $457.09 | $457.09 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $1,621.81 | Professional | 53 · Discontinued | $186.21 | $186.21 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $6,165.95 | Professional | 54 · Surgery only | $691.83 | $691.83 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $1,230.27 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $812.83 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $5,754.40 |
Where Wisconsin sits
The same service costs 8.5 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
$2,455
OK $3,162TX $372
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.