How much rates vary
Facilitymedian $4,786 · 10th to 90th $776 to $16,218Professionalmedian $2,512 · 10th to 90th $955 to $5,012
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 $1,000.00 Median $1,000.00 Typical High $14,454.40 | Facility | None | $1,000.00 | $1,000.00 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $7,943.28 | Professional | None | $1,000.00 | $1,000.00 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,128.31 Typical High $11,748.98 | Facility | None | $5,011.87 | $8,128.31 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $2,951.21 Typical High $5,370.32 | Professional | None | $954.99 | $2,951.21 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $1,862.09 Typical High $3,388.44 | Professional | 62 · Two surgeons | $602.56 | $1,862.09 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $467.74 Typical High $851.14 | Professional | 80 · Assistant surgeon | $165.96 | $467.74 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $416.87 Typical High $758.58 | Professional | AS · PA/NP assist | $134.90 | $416.87 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $3,388.44 | Facility | None | $812.83 | $1,995.26 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,047.13 | $1,698.24 | $3,162.28 |
DeanCare Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $5,888.44 | Facility | None | $912.01 | $3,235.94 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,380.38 | $2,041.74 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,511.89 Typical High $5,370.32 | Professional | None | $912.01 | $2,511.89 | $5,370.32 |
Network Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,089.30 | Facility | None | $1,148.15 | $1,621.81 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,949.84 | $2,570.40 |
Prevea360 Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $1,659.59 | Facility | None | $707.95 | $933.25 | $1,659.59 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $2,041.74 Typical High $3,311.31 | Professional | None | $891.25 | $2,041.74 | $3,311.31 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,047.13 | $2,570.40 |
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 $1,995.26 Median $3,981.07 Typical High $4,677.35 | Professional | None | $1,995.26 | $3,981.07 | $4,677.35 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $794.33 Median $2,344.23 Typical High $3,801.89 | Professional | None | $794.33 | $2,344.23 | $3,801.89 |
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 $501.19 Median $501.19 Typical High $3,981.07 | Professional | 52 · Reduced service | $501.19 | $501.19 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $1,584.89 | Professional | 53 · Discontinued | $199.53 | $199.53 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $6,025.60 | Professional | 54 · Surgery only | $741.31 | $741.31 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $1,202.26 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $794.33 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $5,623.41 |
Where Wisconsin sits
The same service costs 6.2 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
$2,754
AK $3,311TX $537
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.