How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,072 to $9,120Professionalmedian $1,445 · 10th to 90th $427 to $3,162
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 $426.58 Median $6,456.54 Typical High $14,454.40 | Facility | None | $426.58 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $3,801.89 | Professional | None | $426.58 | $426.58 | $3,801.89 |
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 $537.03 Median $1,698.24 Typical High $3,388.44 | Professional | None | $537.03 | $1,698.24 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $269.15 Typical High $537.03 | Professional | 80 · Assistant surgeon | $85.11 | $269.15 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $234.42 Typical High $467.74 | Professional | AS · PA/NP assist | $74.13 | $234.42 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $3,467.37 | Facility | None | $1,122.02 | $2,041.74 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $2,089.30 | Professional | None | $676.08 | $933.25 | $2,089.30 |
DeanCare Setting Facility Modifier None Typical Low $467.74 Median $5,128.61 Typical High $9,772.37 | Facility | None | $467.74 | $5,128.61 | $9,772.37 |
DeanCare Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,445.44 | Professional | None | $776.25 | $1,148.15 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,162.28 Typical High $8,317.64 | Facility | None | $724.44 | $3,162.28 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,380.38 Typical High $2,691.53 | Professional | None | $489.78 | $1,380.38 | $2,691.53 |
Network Health Setting Facility Modifier None Typical Low $1,737.80 Median $5,754.40 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,754.40 | $7,762.47 |
Network Health Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,905.46 | Professional | None | $630.96 | $1,096.48 | $1,905.46 |
Prevea360 Setting Facility Modifier None Typical Low $398.11 Median $467.74 Typical High $891.25 | Facility | None | $398.11 | $467.74 | $891.25 |
Quartz Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $1,862.09 | Professional | None | $478.63 | $1,096.48 | $1,862.09 |
Quartz Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $3,801.89 | Facility | None | $1,479.11 | $2,454.71 | $3,801.89 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,659.59 | Professional | None | $741.31 | $758.58 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Security Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,412.54 | $2,630.27 | $3,019.95 |
The Alliance Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,235.94 | Professional | None | $1,513.56 | $2,511.89 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,288.25 Typical High $2,344.23 | Professional | None | $426.58 | $1,288.25 | $2,344.23 |
2 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 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $2,818.38 | Professional | 54 · Surgery only | $316.23 | $316.23 | $2,818.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $2,630.27 |
Where Wisconsin sits
The same service costs 4.9 times more in Wisconsin than in Montana. 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 $7,069MT $1,449
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.