How much rates vary
Facilitymedian $7,943 · 10th to 90th $891 to $18,197Professionalmedian $4,898 · 10th to 90th $1,905 to $9,772
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 $1,949.84 Median $1,949.84 Typical High $14,454.40 | Facility | None | $1,949.84 | $1,949.84 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $14,791.08 | Professional | None | $1,949.84 | $1,949.84 | $14,791.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $12,302.69 Typical High $18,620.87 | Facility | None | $9,120.11 | $12,302.69 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $5,754.40 Typical High $10,471.29 | Professional | None | $1,905.46 | $5,754.40 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $3,630.78 Typical High $6,606.93 | Professional | 62 · Two surgeons | $1,174.90 | $3,630.78 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $912.01 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $302.00 | $912.01 | $1,659.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $812.83 Typical High $1,479.11 | Professional | AS · PA/NP assist | $263.03 | $812.83 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,890.45 Typical High $6,025.60 | Facility | None | $812.83 | $3,890.45 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,235.94 | $5,623.41 |
DeanCare Setting Facility Modifier None Typical Low $1,778.28 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,778.28 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $5,248.07 | Professional | None | $2,691.53 | $3,981.07 | $5,248.07 |
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 $1,778.28 Median $4,897.79 Typical High $10,471.29 | Professional | None | $1,778.28 | $4,897.79 | $10,471.29 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $3,162.28 | Facility | None | $2,089.30 | $2,238.72 | $3,162.28 |
Network Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $5,128.61 | Professional | None | $2,187.76 | $3,801.89 | $5,128.61 |
Prevea360 Setting Facility Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,311.31 | Facility | None | $1,380.38 | $1,819.70 | $3,311.31 |
Quartz Setting Professional Modifier None Typical Low $1,698.24 Median $3,890.45 Typical High $6,456.54 | Professional | None | $1,698.24 | $3,890.45 | $6,456.54 |
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 $2,570.40 Median $2,630.27 Typical High $5,011.87 | Professional | None | $2,570.40 | $2,630.27 | $5,011.87 |
Security Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $7,762.47 Typical High $9,120.11 | Professional | None | $3,890.45 | $7,762.47 | $9,120.11 |
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 $1,548.82 Median $4,570.88 Typical High $7,413.10 | Professional | None | $1,548.82 | $4,570.88 | $7,413.10 |
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 $977.24 Median $977.24 Typical High $7,413.10 | Professional | 52 · Reduced service | $977.24 | $977.24 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $2,951.21 | Professional | 53 · Discontinued | $389.05 | $389.05 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $11,220.18 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $11,220.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $2,238.72 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $2,238.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $10,471.29 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $10,471.29 |
Where Wisconsin sits
The same service costs 6.3 times more in Alaska than in Washington. 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.
Physician feeFacility fee
AK $13,870WA $2,208
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.