How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,122 to $11,220Professionalmedian $1,514 · 10th to 90th $575 to $4,266
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 $575.44 Median $3,090.30 Typical High $14,454.40 | Facility | None | $575.44 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $5,754.40 | Professional | None | $575.44 | $575.44 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $2,089.30 Typical High $4,365.16 | Professional | None | $562.34 | $2,089.30 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $3,090.30 Typical High $6,456.54 | Professional | 50 · Both sides | $831.76 | $3,090.30 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $1,318.26 Typical High $2,691.53 | Professional | 62 · Two surgeons | $354.81 | $1,318.26 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $5,248.07 | Facility | None | $1,000.00 | $2,187.76 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $2,754.23 | Professional | None | $954.99 | $1,071.52 | $2,754.23 |
DeanCare Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $5,888.44 | Facility | None | $691.83 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,258.93 | $1,819.70 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,905.46 Typical High $2,754.23 | Professional | 50 · Both sides | $1,548.82 | $1,905.46 | $2,754.23 |
DeanCare Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $794.33 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $794.33 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $11,481.54 | Facility | None | $912.01 | $5,623.41 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,862.09 Typical High $6,456.54 | Professional | None | $645.65 | $1,862.09 | $6,456.54 |
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 $724.44 Median $1,380.38 Typical High $1,778.28 | Professional | None | $724.44 | $1,380.38 | $1,778.28 |
Prevea360 Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $1,202.26 | Facility | None | $575.44 | $691.83 | $1,202.26 |
Quartz Setting Professional Modifier None Typical Low $616.60 Median $1,412.54 Typical High $2,511.89 | Professional | None | $616.60 | $1,412.54 | $2,511.89 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $5,754.40 | Facility | None | $724.44 | $3,467.37 | $5,754.40 |
Quartz Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,047.13 | $1,348.96 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,884.03 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,884.03 | $4,073.80 |
The Alliance Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $6,760.83 | Professional | None | $2,691.53 | $3,467.37 | $6,760.83 |
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 $588.84 Median $1,258.93 Typical High $2,818.38 | Professional | None | $588.84 | $1,258.93 | $2,818.38 |
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 $288.40 Median $288.40 Typical High $2,884.03 | Professional | 52 · Reduced service | $288.40 | $288.40 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $1,148.15 | Professional | 53 · Discontinued | $114.82 | $114.82 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $4,265.80 | Professional | 54 · Surgery only | $436.52 | $436.52 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $851.14 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $575.44 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $3,981.07 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $512.86 Median $630.96 Typical High $912.01 | Professional | 51 · Multiple procedures | $512.86 | $630.96 | $912.01 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,445.44 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,445.44 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | 55 · Aftercare only | $204.17 | $251.19 | $363.08 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $870.96 | $1,071.52 | $1,548.82 |
Where Wisconsin sits
The same service costs 7.9 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
$2,042
AK $2,455TX $309
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.