How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,479 to $14,454Professionalmedian $3,715 · 10th to 90th $1,318 to $7,586
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 $1,513.56 Median $8,317.64 Typical High $14,454.40 | Facility | None | $1,513.56 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $12,302.69 | Professional | None | $1,513.56 | $1,513.56 | $12,302.69 |
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 $1,479.11 Median $4,570.88 Typical High $8,128.31 | Professional | None | $1,479.11 | $4,570.88 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $6,760.83 Typical High $12,022.64 | Professional | 50 · Both sides | $2,238.72 | $6,760.83 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $724.44 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $239.88 | $724.44 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $630.96 Typical High $1,122.02 | Professional | AS · PA/NP assist | $208.93 | $630.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $4,073.80 Typical High $7,585.78 | Facility | None | $1,202.26 | $4,073.80 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $4,168.69 | Professional | None | $1,479.11 | $2,511.89 | $4,168.69 |
DeanCare Setting Facility Modifier None Typical Low $1,288.25 Median $5,128.61 Typical High $9,332.54 | Facility | None | $1,288.25 | $5,128.61 | $9,332.54 |
DeanCare Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,089.30 | $3,090.30 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $6,606.93 Typical High $15,848.93 | Facility | None | $1,230.27 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,762.47 | Professional | None | $1,288.25 | $3,467.37 | $7,762.47 |
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 $1,698.24 Median $2,951.21 Typical High $3,890.45 | Professional | None | $1,698.24 | $2,951.21 | $3,890.45 |
Prevea360 Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,238.72 | Facility | None | $933.25 | $1,288.25 | $2,238.72 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $2,691.53 Typical High $5,128.61 | Professional | None | $1,174.90 | $2,691.53 | $5,128.61 |
Quartz Setting Facility Modifier None Typical Low $933.25 Median $5,011.87 Typical High $8,317.64 | Facility | None | $933.25 | $5,011.87 | $8,317.64 |
Quartz Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,584.89 | $1,584.89 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Security Health Setting Professional Modifier None Typical Low $2,754.23 Median $5,623.41 Typical High $7,079.46 | Professional | None | $2,754.23 | $5,623.41 | $7,079.46 |
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 $1,047.13 Median $3,388.44 Typical High $5,248.07 | Professional | None | $1,047.13 | $3,388.44 | $5,248.07 |
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 $741.31 Median $741.31 Typical High $6,165.95 | Professional | 52 · Reduced service | $741.31 | $741.31 | $6,165.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $2,454.71 | Professional | 53 · Discontinued | $302.00 | $302.00 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $9,120.11 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $1,862.09 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $1,862.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $8,511.38 |
Where Wisconsin sits
The same service costs 6.9 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
$4,467
AK $4,786TX $692
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.