How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,259 to $10,965Professionalmedian $2,630 · 10th to 90th $912 to $7,244
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 $1,258.93 Median $6,456.54 Typical High $14,454.40 | Facility | None | $1,258.93 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $10,471.29 | Professional | None | $1,258.93 | $1,258.93 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $3,548.13 Typical High $6,760.83 | Professional | None | $933.25 | $3,548.13 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $5,248.07 Typical High $10,232.93 | Professional | 50 · Both sides | $1,412.54 | $5,248.07 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $2,187.76 Typical High $4,265.80 | Professional | 62 · Two surgeons | $588.84 | $2,187.76 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $562.34 Typical High $1,096.48 | Professional | 80 · Assistant surgeon | $151.36 | $562.34 | $1,096.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $489.78 Typical High $954.99 | Professional | AS · PA/NP assist | $131.83 | $489.78 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $4,570.88 | Facility | None | $954.99 | $2,818.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,819.70 Typical High $4,570.88 | Professional | None | $676.08 | $1,819.70 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,023.29 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,621.81 | $2,290.87 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,096.48 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,951.21 Typical High $7,244.36 | Professional | None | $954.99 | $2,951.21 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,467.37 | Professional | None | $2,089.30 | $2,089.30 | $3,467.37 |
Prevea360 Setting Facility Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,819.70 | Facility | None | $812.83 | $1,071.52 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,981.07 | Professional | None | $851.14 | $1,778.28 | $3,981.07 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $4,786.30 | Facility | None | $758.58 | $2,884.03 | $4,786.30 |
Quartz Setting Professional Modifier None Typical Low $676.08 Median $1,819.70 Typical High $1,949.84 | Professional | None | $676.08 | $1,819.70 | $1,949.84 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Security Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,888.44 Typical High $8,912.51 | Professional | None | $3,548.13 | $5,888.44 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,905.46 Typical High $4,265.80 | Professional | None | $870.96 | $1,905.46 | $4,265.80 |
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 $630.96 Median $630.96 Typical High $5,128.61 | Professional | 52 · Reduced service | $630.96 | $630.96 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $2,089.30 | Professional | 53 · Discontinued | $251.19 | $251.19 | $2,089.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $7,762.47 | Professional | 54 · Surgery only | $954.99 | $954.99 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $1,548.82 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $1,047.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $7,244.36 |
Where Wisconsin sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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
WI $8,254FL $2,626
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.