How much rates vary
Facilitymedian $7,943 · 10th to 90th $813 to $19,498Professionalmedian $4,467 · 10th to 90th $1,349 to $9,120
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 $1,288.25 Median $1,288.25 Typical High $14,454.40 | Facility | None | $1,288.25 | $1,288.25 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $23,988.33 | Professional | None | $1,288.25 | $1,288.25 | $23,988.33 |
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 $1,737.80 Median $5,248.07 Typical High $9,332.54 | Professional | None | $1,737.80 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $3,311.31 Typical High $5,888.44 | Professional | 62 · Two surgeons | $1,096.48 | $3,311.31 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $831.76 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $275.42 | $831.76 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $741.31 Typical High $1,318.26 | Professional | AS · PA/NP assist | $239.88 | $741.31 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $5,623.41 | Facility | None | $812.83 | $3,630.78 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $6,606.93 | Professional | None | $2,238.72 | $2,951.21 | $6,606.93 |
DeanCare Setting Facility Modifier None Typical Low $1,513.56 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,513.56 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $4,897.79 | Professional | None | $2,511.89 | $3,715.35 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $10,232.93 | Professional | None | $1,380.38 | $3,801.89 | $10,232.93 |
Network Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $2,137.96 | Facility | None | $2,041.74 | $2,089.30 | $2,137.96 |
Network Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $6,456.54 | Professional | None | $2,041.74 | $3,311.31 | $6,456.54 |
Prevea360 Setting Facility Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $3,090.30 | Facility | None | $1,258.93 | $1,513.56 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $6,025.60 | Professional | None | $1,621.81 | $3,801.89 | $6,025.60 |
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 $2,454.71 Median $2,630.27 Typical High $5,370.32 | Professional | None | $2,454.71 | $2,630.27 | $5,370.32 |
Security Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Security Health Setting Professional Modifier None Typical Low $4,168.69 Median $8,128.31 Typical High $10,000.00 | Professional | None | $4,168.69 | $8,128.31 | $10,000.00 |
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 $1,380.38 Median $3,715.35 Typical High $7,762.47 | Professional | None | $1,380.38 | $3,715.35 | $7,762.47 |
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 $645.65 Median $645.65 Typical High $12,022.64 | Professional | 52 · Reduced service | $645.65 | $645.65 | $12,022.64 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $4,786.30 | Professional | 53 · Discontinued | $257.04 | $257.04 | $4,786.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $17,782.79 | Professional | 54 · Surgery only | $954.99 | $954.99 | $17,782.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $3,548.13 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $3,548.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $2,398.83 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $2,398.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $16,595.87 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $16,595.87 |
Where Wisconsin sits
The same service costs 8.5 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
$4,786
AK $6,166TX $724
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.