How much rates vary
Facilitymedian $6,607 · 10th to 90th $813 to $17,783Professionalmedian $5,370 · 10th to 90th $1,698 to $10,000
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 $1,584.89 Median $1,584.89 Typical High $14,454.40 | Facility | None | $1,584.89 | $1,584.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $16,982.44 | Professional | None | $1,584.89 | $1,584.89 | $16,982.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $18,620.87 | Facility | None | $6,309.57 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $6,165.95 Typical High $11,220.18 | Professional | None | $2,187.76 | $6,165.95 | $11,220.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,235.94 Median $8,709.64 Typical High $16,982.44 | Professional | 50 · Both sides | $3,235.94 | $8,709.64 | $16,982.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $3,890.45 Typical High $7,079.46 | Professional | 62 · Two surgeons | $1,380.38 | $3,890.45 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $977.24 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $346.74 | $977.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $870.96 Typical High $1,584.89 | Professional | AS · PA/NP assist | $302.00 | $870.96 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,466.84 Typical High $6,918.31 | Facility | None | $812.83 | $4,466.84 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $6,606.93 | Professional | None | $2,290.87 | $3,630.78 | $6,606.93 |
DeanCare Setting Facility Modifier None Typical Low $1,905.46 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,905.46 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,090.30 Median $4,570.88 Typical High $5,754.40 | Professional | None | $3,090.30 | $4,570.88 | $5,754.40 |
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 $1,995.26 Median $5,370.32 Typical High $11,220.18 | Professional | None | $1,995.26 | $5,370.32 | $11,220.18 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,570.40 | $3,630.78 |
Network Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $5,623.41 | Professional | None | $2,511.89 | $4,365.16 | $5,623.41 |
Prevea360 Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,548.13 | Facility | None | $1,584.89 | $2,041.74 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $1,659.59 Median $3,801.89 Typical High $7,413.10 | Professional | None | $1,659.59 | $3,801.89 | $7,413.10 |
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 $2,344.23 Median $2,344.23 Typical High $5,248.07 | Professional | None | $2,344.23 | $2,344.23 | $5,248.07 |
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 $5,370.32 Median $7,585.78 Typical High $9,772.37 | Professional | None | $5,370.32 | $7,585.78 | $9,772.37 |
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 $1,698.24 Median $4,786.30 Typical High $9,120.11 | Professional | None | $1,698.24 | $4,786.30 | $9,120.11 |
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 $794.33 Median $794.33 Typical High $8,511.38 | Professional | 52 · Reduced service | $794.33 | $794.33 | $8,511.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $3,388.44 | Professional | 53 · Discontinued | $316.23 | $316.23 | $3,388.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $12,882.50 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $12,882.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $2,570.40 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $2,570.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $1,698.24 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $1,698.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $12,022.64 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $12,022.64 |
Where Wisconsin sits
The same service costs 21.9 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
$5,495
AK $7,079TX $324
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.