How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,230 to $16,218Professionalmedian $1,820 · 10th to 90th $575 to $4,467
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 $562.34 Median $8,317.64 Typical High $14,454.40 | Facility | None | $562.34 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $8,317.64 | Professional | None | $562.34 | $562.34 | $8,317.64 |
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 $741.31 Median $1,995.26 Typical High $4,570.88 | Professional | None | $741.31 | $1,995.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $1,258.93 Typical High $2,884.03 | Professional | 62 · Two surgeons | $467.74 | $1,258.93 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $323.59 Typical High $724.44 | Professional | 80 · Assistant surgeon | $120.23 | $323.59 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $281.84 Typical High $645.65 | Professional | AS · PA/NP assist | $104.71 | $281.84 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $7,585.78 | Facility | None | $1,202.26 | $2,630.27 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,137.96 | Professional | None | $933.25 | $1,318.26 | $2,137.96 |
DeanCare Setting Facility Modifier None Typical Low $660.69 Median $5,128.61 Typical High $9,332.54 | Facility | None | $660.69 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,584.89 | $1,905.46 |
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 $676.08 Median $1,548.82 Typical High $3,388.44 | Professional | None | $676.08 | $1,548.82 | $3,388.44 |
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 $870.96 Median $1,513.56 Typical High $1,862.09 | Professional | None | $870.96 | $1,513.56 | $1,862.09 |
Prevea360 Setting Facility Modifier None Typical Low $562.34 Median $691.83 Typical High $1,174.90 | Facility | None | $562.34 | $691.83 | $1,174.90 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $1,348.96 Typical High $2,570.40 | Professional | None | $588.84 | $1,348.96 | $2,570.40 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $5,128.61 Typical High $8,317.64 | Facility | None | $933.25 | $5,128.61 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,122.02 | $1,778.28 |
Security Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Security Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $4,168.69 | Professional | None | $2,344.23 | $3,630.78 | $4,168.69 |
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 $537.03 Median $1,513.56 Typical High $2,754.23 | Professional | None | $537.03 | $1,513.56 | $2,754.23 |
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 $281.84 Median $281.84 Typical High $4,168.69 | Professional | 52 · Reduced service | $281.84 | $281.84 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $1,659.59 | Professional | 53 · Discontinued | $112.20 | $112.20 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $6,309.57 | Professional | 54 · Surgery only | $426.58 | $426.58 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $1,258.93 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $831.76 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $5,888.44 |
Where Wisconsin sits
The same service costs 8.1 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· 4th of 51
$2,344
OK $3,467UT $427
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.