How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,230 to $14,454Professionalmedian $1,778 · 10th to 90th $708 to $5,248
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 $707.95 Median $8,511.38 Typical High $14,454.40 | Facility | None | $707.95 | $8,511.38 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $12,302.69 | Professional | None | $707.95 | $707.95 | $12,302.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,762.47 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,762.47 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $2,398.83 Typical High $5,248.07 | Professional | None | $691.83 | $2,398.83 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $3,548.13 Typical High $7,943.28 | Professional | 50 · Both sides | $1,023.29 | $3,548.13 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $1,513.56 Typical High $3,311.31 | Professional | 62 · Two surgeons | $436.52 | $1,513.56 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $5,248.07 | Facility | None | $1,023.29 | $2,691.53 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,258.93 | $3,311.31 |
DeanCare Setting Facility Modifier None Typical Low $794.33 Median $7,943.28 Typical High $14,454.40 | Facility | None | $794.33 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,548.82 | $2,238.72 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,290.87 Typical High $3,311.31 | Professional | 50 · Both sides | $1,862.09 | $2,290.87 | $3,311.31 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $977.24 Typical High $1,380.38 | Professional | 62 · Two surgeons | $794.33 | $977.24 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $6,456.54 Typical High $15,135.61 | Facility | None | $977.24 | $6,456.54 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,862.09 Typical High $5,370.32 | Professional | None | $776.25 | $1,862.09 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $10,715.19 Typical High $17,378.01 | Facility | None | $2,089.30 | $10,715.19 | $17,378.01 |
Network Health Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,089.30 | Professional | None | $891.25 | $1,584.89 | $2,089.30 |
Prevea360 Setting Facility Modifier None Typical Low $660.69 Median $831.76 Typical High $1,445.44 | Facility | None | $660.69 | $831.76 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,737.80 Typical High $3,090.30 | Professional | None | $758.58 | $1,737.80 | $3,090.30 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $5,754.40 | Facility | None | $812.83 | $3,467.37 | $5,754.40 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $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 $2,238.72 Median $3,467.37 Typical High $5,011.87 | Professional | None | $2,238.72 | $3,467.37 | $5,011.87 |
The Alliance Setting Professional Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,265.80 | $4,786.30 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,698.24 | $8,912.51 | $15,488.17 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $3,467.37 | Professional | None | $724.44 | $1,445.44 | $3,467.37 |
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 $354.81 Median $354.81 Typical High $6,165.95 | Professional | 52 · Reduced service | $354.81 | $354.81 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $2,454.71 | Professional | 53 · Discontinued | $141.25 | $141.25 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $9,332.54 | Professional | 54 · Surgery only | $524.81 | $524.81 | $9,332.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $1,862.09 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $8,709.64 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $8,709.64 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $630.96 Median $776.25 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $630.96 | $776.25 | $1,096.48 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,230.27 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,000.00 | $1,230.27 | $1,778.28 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | 55 · Aftercare only | $251.19 | $309.03 | $446.68 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,288.25 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,288.25 | $1,862.09 |
Where Wisconsin sits
The same service costs 7.6 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
$2,291
AK $2,951TX $389
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.