How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,995 to $14,454Professionalmedian $4,898 · 10th to 90th $1,820 to $10,233
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 $1,995.26 Median $11,220.18 Typical High $14,454.40 | Facility | None | $1,995.26 | $11,220.18 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $25,703.96 | Professional | None | $1,995.26 | $1,995.26 | $25,703.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $6,025.60 Typical High $10,964.78 | Professional | None | $1,995.26 | $6,025.60 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $3,801.89 Typical High $6,918.31 | Professional | 62 · Two surgeons | $1,258.93 | $3,801.89 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $5,888.44 | Professional | None | $2,041.74 | $3,311.31 | $5,888.44 |
DeanCare Setting Facility Modifier None Typical Low $1,737.80 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,737.80 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $5,128.61 | Professional | None | $2,818.38 | $4,168.69 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,412.54 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $4,897.79 Typical High $10,964.78 | Professional | None | $1,778.28 | $4,897.79 | $10,964.78 |
Network Health Setting Facility Modifier None Typical Low $3,981.07 Median $9,332.54 Typical High $15,848.93 | Facility | None | $3,981.07 | $9,332.54 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,890.45 Typical High $5,128.61 | Professional | None | $2,290.87 | $3,890.45 | $5,128.61 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $3,162.28 | Facility | None | $933.25 | $1,819.70 | $3,162.28 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $3,715.35 Typical High $6,760.83 | Professional | None | $1,621.81 | $3,715.35 | $6,760.83 |
Quartz Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $8,317.64 | Facility | None | $1,995.26 | $5,495.41 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $5,128.61 | Professional | None | $2,137.96 | $2,137.96 | $5,128.61 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Security Health Setting Professional Modifier None Typical Low $3,467.37 Median $7,585.78 Typical High $9,549.93 | Professional | None | $3,467.37 | $7,585.78 | $9,549.93 |
The Alliance Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $12,022.64 | Professional | None | $9,549.93 | $9,549.93 | $12,022.64 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $4,570.88 Typical High $7,244.36 | Professional | None | $1,445.44 | $4,570.88 | $7,244.36 |
6 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 $1,000.00 Median $1,000.00 Typical High $12,882.50 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $12,882.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $5,128.61 | Professional | 53 · Discontinued | $398.11 | $398.11 | $5,128.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $19,498.45 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $19,498.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $3,890.45 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $3,890.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $2,570.40 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $2,570.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $18,197.01 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $18,197.01 |
Where Wisconsin sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$5,754
AK $6,457UT $1,023
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.