How much rates vary
Facilitymedian $2,818 · 10th to 90th $813 to $6,026Professionalmedian $1,698 · 10th to 90th $676 to $5,012
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 $676.08 Median $6,456.54 Typical High $14,454.40 | Facility | None | $676.08 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $7,585.78 | Professional | None | $676.08 | $676.08 | $7,585.78 |
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 $660.69 Median $2,630.27 Typical High $5,011.87 | Professional | None | $660.69 | $2,630.27 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $1,659.59 Typical High $3,162.28 | Professional | 62 · Two surgeons | $416.87 | $1,659.59 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,819.70 Typical High $2,691.53 | Facility | None | $954.99 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $3,548.13 | Professional | None | $1,096.48 | $1,230.27 | $3,548.13 |
DeanCare Setting Facility Modifier None Typical Low $794.33 Median $4,365.16 Typical High $7,762.47 | Facility | None | $794.33 | $4,365.16 | $7,762.47 |
DeanCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,479.11 | $2,089.30 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $5,128.61 | Facility | None | $691.83 | $2,398.83 | $5,128.61 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,778.28 Typical High $5,370.32 | Professional | None | $724.44 | $1,778.28 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $851.14 Median $1,548.82 Typical High $1,995.26 | Professional | None | $851.14 | $1,548.82 | $1,995.26 |
Prevea360 Setting Facility Modifier None Typical Low $691.83 Median $794.33 Typical High $1,230.27 | Facility | None | $691.83 | $794.33 | $1,230.27 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $2,951.21 | Professional | None | $758.58 | $1,737.80 | $2,951.21 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,584.89 Typical High $2,691.53 | Facility | None | $758.58 | $1,584.89 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,230.27 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $1,096.48 Median $3,388.44 Typical High $4,897.79 | Professional | None | $1,096.48 | $3,388.44 | $4,897.79 |
The Alliance Setting Professional Modifier None Typical Low $3,235.94 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,235.94 | $4,265.80 | $5,248.07 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,677.35 | Facility | None | $707.95 | $2,818.38 | $4,677.35 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,380.38 Typical High $3,235.94 | Professional | None | $691.83 | $1,380.38 | $3,235.94 |
10 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 $338.84 Median $338.84 Typical High $3,801.89 | Professional | 52 · Reduced service | $338.84 | $338.84 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $1,513.56 | Professional | 53 · Discontinued | $134.90 | $134.90 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $5,623.41 | Professional | 54 · Surgery only | $501.19 | $501.19 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $1,122.02 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $758.58 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $5,248.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $602.56 Median $741.31 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $602.56 | $741.31 | $1,047.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,698.24 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,698.24 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $295.12 Typical High $416.87 | Professional | 55 · Aftercare only | $239.88 | $295.12 | $416.87 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,230.27 | $1,778.28 |
Where Wisconsin sits
The same service costs 3.8 times more in Alaska than in Maryland. 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 $5,702MD $1,505
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.