How much rates vary
Facilitymedian $7,943 · 10th to 90th $813 to $19,498Professionalmedian $7,244 · 10th to 90th $2,239 to $14,454
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 $1,949.84 Median $1,949.84 Typical High $14,454.40 | Facility | None | $1,949.84 | $1,949.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $26,915.35 | Professional | None | $1,949.84 | $1,949.84 | $26,915.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $15,488.17 Typical High $26,302.68 | Facility | None | $10,964.78 | $15,488.17 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $8,317.64 Typical High $14,454.40 | Professional | None | $2,630.27 | $8,317.64 | $14,454.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $5,248.07 Typical High $9,120.11 | Professional | 62 · Two surgeons | $1,659.59 | $5,248.07 | $9,120.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $1,348.96 Typical High $2,344.23 | Professional | 80 · Assistant surgeon | $426.58 | $1,348.96 | $2,344.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $1,174.90 Typical High $2,041.74 | Professional | AS · PA/NP assist | $371.54 | $1,174.90 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,495.41 Typical High $8,511.38 | Facility | None | $812.83 | $5,495.41 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $4,897.79 Typical High $10,232.93 | Professional | None | $3,467.37 | $4,897.79 | $10,232.93 |
DeanCare Setting Facility Modifier None Typical Low $2,344.23 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,344.23 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,801.89 Median $5,623.41 Typical High $7,762.47 | Professional | None | $3,801.89 | $5,623.41 | $7,762.47 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,511.89 Median $6,918.31 Typical High $15,848.93 | Professional | None | $2,511.89 | $6,918.31 | $15,848.93 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $4,365.16 | Facility | None | $2,089.30 | $3,090.30 | $4,365.16 |
Network Health Setting Professional Modifier None Typical Low $3,090.30 Median $5,370.32 Typical High $10,000.00 | Professional | None | $3,090.30 | $5,370.32 | $10,000.00 |
Prevea360 Setting Facility Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,949.84 | $2,511.89 | $4,897.79 |
Quartz Setting Professional Modifier None Typical Low $2,454.71 Median $5,623.41 Typical High $9,120.11 | Professional | None | $2,454.71 | $5,623.41 | $9,120.11 |
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 $3,801.89 Median $4,073.80 Typical High $8,317.64 | Professional | None | $3,801.89 | $4,073.80 | $8,317.64 |
Security Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Security Health Setting Professional Modifier None Typical Low $7,762.47 Median $12,302.69 Typical High $15,488.17 | Professional | None | $7,762.47 | $12,302.69 | $15,488.17 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $6,456.54 Typical High $12,022.64 | Professional | None | $2,238.72 | $6,456.54 | $12,022.64 |
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 $977.24 Median $977.24 Typical High $13,489.63 | Professional | 52 · Reduced service | $977.24 | $977.24 | $13,489.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $5,370.32 | Professional | 53 · Discontinued | $398.11 | $398.11 | $5,370.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $19,952.62 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $19,952.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $3,981.07 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $3,981.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $2,691.53 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $2,691.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $18,620.87 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $18,620.87 |
Where Wisconsin sits
The same service costs 7.6 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
$7,244
AK $9,550TX $1,259
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.