How much rates vary
Facilitymedian $8,710 · 10th to 90th $813 to $19,498Professionalmedian $12,303 · 10th to 90th $3,802 to $24,547
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 $3,388.44 Median $3,388.44 Typical High $14,454.40 | Facility | None | $3,388.44 | $3,388.44 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $36,307.81 | Professional | None | $3,388.44 | $3,388.44 | $36,307.81 |
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 $4,570.88 Median $14,454.40 Typical High $25,118.86 | Professional | None | $4,570.88 | $14,454.40 | $25,118.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,884.03 Median $9,120.11 Typical High $15,848.93 | Professional | 62 · Two surgeons | $2,884.03 | $9,120.11 | $15,848.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $2,344.23 Typical High $4,073.80 | Professional | 80 · Assistant surgeon | $724.44 | $2,344.23 | $4,073.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $645.65 Median $2,041.74 Typical High $3,548.13 | Professional | AS · PA/NP assist | $645.65 | $2,041.74 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $9,549.93 Typical High $14,791.08 | Facility | None | $812.83 | $9,549.93 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $5,888.44 Median $8,511.38 Typical High $17,378.01 | Professional | None | $5,888.44 | $8,511.38 | $17,378.01 |
DeanCare Setting Facility Modifier None Typical Low $4,073.80 Median $7,943.28 Typical High $14,454.40 | Facility | None | $4,073.80 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $6,606.93 Median $9,772.37 Typical High $13,489.63 | Professional | None | $6,606.93 | $9,772.37 | $13,489.63 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,951.21 Typical High $18,197.01 | Facility | None | $436.52 | $2,951.21 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $4,365.16 Median $12,022.64 Typical High $27,542.29 | Professional | None | $4,365.16 | $12,022.64 | $27,542.29 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $5,370.32 Typical High $7,585.78 | Facility | None | $2,089.30 | $5,370.32 | $7,585.78 |
Network Health Setting Professional Modifier None Typical Low $5,370.32 Median $9,332.54 Typical High $17,378.01 | Professional | None | $5,370.32 | $9,332.54 | $17,378.01 |
Prevea360 Setting Facility Modifier None Typical Low $3,388.44 Median $4,265.80 Typical High $8,511.38 | Facility | None | $3,388.44 | $4,265.80 | $8,511.38 |
Quartz Setting Professional Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $15,848.93 | Professional | None | $4,265.80 | $9,772.37 | $15,848.93 |
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 $6,456.54 Median $7,079.46 Typical High $14,454.40 | Professional | None | $6,456.54 | $7,079.46 | $14,454.40 |
Security Health Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Professional | None | $12,882.50 | $12,882.50 | $12,882.50 |
Security Health Setting Professional Modifier None Typical Low $13,803.84 Median $21,379.62 Typical High $26,915.35 | Professional | None | $13,803.84 | $21,379.62 | $26,915.35 |
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 $3,801.89 Median $11,220.18 Typical High $20,892.96 | Professional | None | $3,801.89 | $11,220.18 | $20,892.96 |
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 $1,698.24 Median $1,698.24 Typical High $18,197.01 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $18,197.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $7,244.36 | Professional | 53 · Discontinued | $676.08 | $676.08 | $7,244.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $27,542.29 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $27,542.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $5,495.41 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $5,495.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $3,630.78 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $3,630.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,398.83 Typical High $25,703.96 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,398.83 | $25,703.96 |
Where Wisconsin sits
The same service costs 21.4 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
$11,482
AK $16,596TX $776
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.