How much rates vary
Facilitymedian $7,762 · 10th to 90th $813 to $18,197Professionalmedian $3,020 · 10th to 90th $1,175 to $6,026
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 $1,202.26 Median $1,202.26 Typical High $14,454.40 | Facility | None | $1,202.26 | $1,202.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $10,964.78 | Professional | None | $1,202.26 | $1,202.26 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $12,882.50 Typical High $21,877.62 | Facility | None | $10,000.00 | $12,882.50 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $3,548.13 Typical High $6,456.54 | Professional | None | $1,174.90 | $3,548.13 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $2,238.72 Typical High $4,073.80 | Professional | 62 · Two surgeons | $724.44 | $2,238.72 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $562.34 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $186.21 | $562.34 | $1,023.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $501.19 Typical High $912.01 | Professional | AS · PA/NP assist | $162.18 | $501.19 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,398.83 Typical High $3,715.35 | Facility | None | $812.83 | $2,398.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,513.56 | $2,041.74 | $3,311.31 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,096.48 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,659.59 | $2,454.71 | $3,235.94 |
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 $1,122.02 Median $3,090.30 Typical High $6,606.93 | Professional | None | $1,122.02 | $3,090.30 | $6,606.93 |
Network Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,089.30 | Facility | None | $1,380.38 | $1,949.84 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,344.23 | $3,162.28 |
Prevea360 Setting Facility Modifier None Typical Low $851.14 Median $1,122.02 Typical High $2,041.74 | Facility | None | $851.14 | $1,122.02 | $2,041.74 |
Quartz Setting Professional Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $3,981.07 | Professional | None | $1,071.52 | $2,454.71 | $3,981.07 |
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 $1,621.81 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,621.81 | $3,090.30 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $2,398.83 Median $4,786.30 Typical High $5,623.41 | Professional | None | $2,398.83 | $4,786.30 | $5,623.41 |
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 $954.99 Median $2,818.38 Typical High $4,570.88 | Professional | None | $954.99 | $2,818.38 | $4,570.88 |
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 $602.56 Median $602.56 Typical High $5,495.41 | Professional | 52 · Reduced service | $602.56 | $602.56 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $2,187.76 | Professional | 53 · Discontinued | $239.88 | $239.88 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $8,317.64 | Professional | 54 · Surgery only | $891.25 | $891.25 | $8,317.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $1,659.59 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $1,659.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $7,762.47 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $7,762.47 |
Where Wisconsin sits
The same service costs 6.8 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
$3,311
AK $3,981TX $589
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.