How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,202 to $16,218Professionalmedian $1,995 · 10th to 90th $631 to $4,898
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 $616.60 Median $3,090.30 Typical High $14,454.40 | Facility | None | $616.60 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $5,754.40 | Professional | None | $616.60 | $616.60 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $2,238.72 Typical High $5,128.61 | Professional | None | $812.83 | $2,238.72 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $1,412.54 Typical High $3,235.94 | Professional | 62 · Two surgeons | $512.86 | $1,412.54 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $354.81 Typical High $812.83 | Professional | 80 · Assistant surgeon | $131.83 | $354.81 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $316.23 Typical High $707.95 | Professional | AS · PA/NP assist | $114.82 | $316.23 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $7,585.78 | Facility | None | $1,000.00 | $2,290.87 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,513.56 | $2,344.23 |
DeanCare Setting Facility Modifier None Typical Low $724.44 Median $3,162.28 Typical High $5,888.44 | Facility | None | $724.44 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,737.80 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $7,943.28 Typical High $16,218.10 | Facility | None | $977.24 | $7,943.28 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $3,801.89 | Professional | None | $758.58 | $1,737.80 | $3,801.89 |
Network Health Setting Facility Modifier None Typical Low $5,011.87 Median $10,715.19 Typical High $17,378.01 | Facility | None | $5,011.87 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,041.74 | Professional | None | $954.99 | $1,659.59 | $2,041.74 |
Prevea360 Setting Facility Modifier None Typical Low $616.60 Median $776.25 Typical High $1,318.26 | Facility | None | $616.60 | $776.25 | $1,318.26 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,818.38 | Professional | None | $691.83 | $1,584.89 | $2,818.38 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $5,128.61 Typical High $8,317.64 | Facility | None | $724.44 | $5,128.61 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,230.27 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $4,570.88 | Professional | None | $2,570.40 | $4,073.80 | $4,570.88 |
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 $616.60 Median $1,659.59 Typical High $3,019.95 | Professional | None | $616.60 | $1,659.59 | $3,019.95 |
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 $309.03 Median $309.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $1,148.15 | Professional | 53 · Discontinued | $123.03 | $123.03 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $4,365.16 | Professional | 54 · Surgery only | $467.74 | $467.74 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $870.96 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $575.44 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $4,073.80 |
Where Wisconsin sits
The same service costs 5.4 times more in Oklahoma than in Hawaii. 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.
Physician feeFacility fee
OK $11,284HI $2,091
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.