How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,175 to $18,197Professionalmedian $1,698 · 10th to 90th $646 to $4,898
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 $645.65 Median $8,317.64 Typical High $14,454.40 | Facility | None | $645.65 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $10,000.00 | Professional | None | $645.65 | $645.65 | $10,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $14,454.40 Typical High $22,387.21 | Facility | None | $8,709.64 | $14,454.40 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $2,344.23 Typical High $5,011.87 | Professional | None | $630.96 | $2,344.23 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $3,467.37 Typical High $7,413.10 | Professional | 50 · Both sides | $954.99 | $3,467.37 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $1,479.11 Typical High $3,090.30 | Professional | 62 · Two surgeons | $398.11 | $1,479.11 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,691.53 Typical High $9,332.54 | Facility | None | $1,023.29 | $2,691.53 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,174.90 | $3,090.30 |
DeanCare Setting Facility Modifier None Typical Low $724.44 Median $5,128.61 Typical High $9,332.54 | Facility | None | $724.44 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,412.54 | $2,041.74 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,137.96 Typical High $3,090.30 | Professional | 50 · Both sides | $1,737.80 | $2,137.96 | $3,090.30 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $891.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $724.44 | $891.25 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $4,466.84 Typical High $12,589.25 | Facility | None | $912.01 | $4,466.84 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,819.70 Typical High $5,754.40 | Professional | None | $707.95 | $1,819.70 | $5,754.40 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $812.83 Median $1,548.82 Typical High $1,995.26 | Professional | None | $812.83 | $1,548.82 | $1,995.26 |
Prevea360 Setting Facility Modifier None Typical Low $602.56 Median $776.25 Typical High $1,348.96 | Facility | None | $602.56 | $776.25 | $1,348.96 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,818.38 | Professional | None | $691.83 | $1,584.89 | $2,818.38 |
Quartz Setting Facility Modifier None Typical Low $812.83 Median $6,165.95 Typical High $10,232.93 | Facility | None | $812.83 | $6,165.95 | $10,232.93 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,174.90 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Security Health Setting Professional Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $4,570.88 | Professional | None | $2,089.30 | $3,311.31 | $4,570.88 |
The Alliance Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $4,897.79 | Professional | None | $2,951.21 | $3,890.45 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,348.96 Typical High $3,235.94 | Professional | None | $691.83 | $1,348.96 | $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 $323.59 Median $323.59 Typical High $5,011.87 | Professional | 52 · Reduced service | $323.59 | $323.59 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $1,995.26 | Professional | 53 · Discontinued | $128.82 | $128.82 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $7,585.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $1,513.56 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $1,513.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $7,079.46 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $7,079.46 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $575.44 Median $707.95 Typical High $1,023.29 | Professional | 51 · Multiple procedures | $575.44 | $707.95 | $1,023.29 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,148.15 Typical High $1,659.59 | Professional | 54 · Surgery only | $933.25 | $1,148.15 | $1,659.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $281.84 Typical High $407.38 | Professional | 55 · Aftercare only | $234.42 | $281.84 | $407.38 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,202.26 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $977.24 | $1,202.26 | $1,737.80 |
Where Wisconsin sits
The same service costs 8.1 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 $2,754TX $339
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.