How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,259 to $7,586Professionalmedian $7,413 · 10th to 90th $2,630 to $12,303
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 $2,238.72 Median $8,317.64 Typical High $14,454.40 | Facility | None | $2,238.72 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $35,481.34 | Professional | None | $2,238.72 | $2,238.72 | $35,481.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $7,585.78 | Facility | None | $2,818.38 | $4,786.30 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $7,943.28 Typical High $12,302.69 | Professional | None | $3,090.30 | $7,943.28 | $12,302.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,949.84 Median $5,011.87 Typical High $7,762.47 | Professional | 62 · Two surgeons | $1,949.84 | $5,011.87 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $1,288.25 Typical High $1,949.84 | Professional | 80 · Assistant surgeon | $489.78 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $1,122.02 Typical High $1,698.24 | Professional | AS · PA/NP assist | $426.58 | $1,122.02 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,818.38 Typical High $8,128.31 | Facility | None | $1,202.26 | $2,818.38 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $4,677.35 Typical High $14,454.40 | Professional | None | $2,818.38 | $4,677.35 | $14,454.40 |
DeanCare Setting Facility Modifier None Typical Low $2,884.03 Median $5,128.61 Typical High $9,332.54 | Facility | None | $2,884.03 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $4,570.88 Median $4,677.35 Typical High $7,762.47 | Professional | None | $4,570.88 | $4,677.35 | $7,762.47 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,754.23 Typical High $6,165.95 | Facility | None | $707.95 | $2,754.23 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $2,818.38 Median $7,413.10 Typical High $19,952.62 | Professional | None | $2,818.38 | $7,413.10 | $19,952.62 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $3,630.78 Median $6,025.60 Typical High $7,413.10 | Professional | None | $3,630.78 | $6,025.60 | $7,413.10 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $2,884.03 Typical High $5,370.32 | Facility | None | $933.25 | $2,884.03 | $5,370.32 |
Quartz Setting Professional Modifier None Typical Low $2,630.27 Median $5,623.41 Typical High $11,220.18 | Professional | None | $2,630.27 | $5,623.41 | $11,220.18 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $2,041.74 Typical High $3,311.31 | Facility | None | $933.25 | $2,041.74 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $6,606.93 | Professional | None | $2,691.53 | $3,019.95 | $6,606.93 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Security Health Setting Professional Modifier None Typical Low $4,677.35 Median $11,220.18 Typical High $13,489.63 | Professional | None | $4,677.35 | $11,220.18 | $13,489.63 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $5,495.41 Typical High $11,220.18 | Professional | None | $2,398.83 | $5,495.41 | $11,220.18 |
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 $1,122.02 Median $1,122.02 Typical High $17,782.79 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $17,782.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $7,079.46 | Professional | 53 · Discontinued | $446.68 | $446.68 | $7,079.46 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $26,302.68 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $26,302.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $5,248.07 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $5,248.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $3,548.13 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $3,548.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $24,547.09 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $24,547.09 |
Where Wisconsin sits
The same service costs 15.8 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· 3rd of 51
$5,248
AK $8,128TX $513
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.