How much rates vary
Facilitymedian $2,951 · 10th to 90th $933 to $6,166Professionalmedian $2,455 · 10th to 90th $851 to $4,074
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 $741.31 Median $8,317.64 Typical High $14,454.40 | Facility | None | $741.31 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $8,709.64 | Professional | None | $741.31 | $741.31 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $4,168.69 | Professional | None | $1,023.29 | $2,691.53 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,659.59 Typical High $2,570.40 | Professional | 62 · Two surgeons | $645.65 | $1,659.59 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $3,388.44 | Facility | None | $1,202.26 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $4,897.79 | Professional | None | $977.24 | $1,548.82 | $4,897.79 |
DeanCare Setting Facility Modifier None Typical Low $954.99 Median $5,128.61 Typical High $9,332.54 | Facility | None | $954.99 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,548.82 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $2,398.83 Typical High $6,309.57 | Facility | None | $707.95 | $2,398.83 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $2,398.83 Typical High $6,606.93 | Professional | None | $933.25 | $2,398.83 | $6,606.93 |
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 $1,202.26 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,995.26 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,737.80 | Facility | None | $794.33 | $954.99 | $1,737.80 |
Quartz Setting Professional Modifier None Typical Low $933.25 Median $1,995.26 Typical High $3,715.35 | Professional | None | $933.25 | $1,995.26 | $3,715.35 |
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 $912.01 Median $977.24 Typical High $2,137.96 | Professional | None | $912.01 | $977.24 | $2,137.96 |
Security Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $1,584.89 Median $3,715.35 Typical High $4,466.84 | Professional | None | $1,584.89 | $3,715.35 | $4,466.84 |
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 $831.76 Median $1,778.28 Typical High $3,715.35 | Professional | None | $831.76 | $1,778.28 | $3,715.35 |
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 $371.54 Median $371.54 Typical High $4,365.16 | Professional | 52 · Reduced service | $371.54 | $371.54 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $1,737.80 | Professional | 53 · Discontinued | $147.91 | $147.91 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $6,456.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $1,288.25 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $870.96 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $6,025.60 |
Where Wisconsin sits
The same service costs 3.7 times more in Alaska than in Delaware. 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
AK $6,515DE $1,768
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.