How much rates vary
Facilitymedian $8,710 · 10th to 90th $891 to $21,380Professionalmedian $7,079 · 10th to 90th $2,512 to $15,849
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 $2,570.40 Median $2,570.40 Typical High $14,454.40 | Facility | None | $2,570.40 | $2,570.40 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $21,877.62 | Professional | None | $2,570.40 | $2,570.40 | $21,877.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $17,782.79 Typical High $26,302.68 | Facility | None | $12,022.64 | $17,782.79 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $7,943.28 Typical High $16,982.44 | Professional | None | $2,238.72 | $7,943.28 | $16,982.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $5,011.87 Typical High $10,000.00 | Professional | 62 · Two surgeons | $1,412.54 | $5,011.87 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $1,288.25 Typical High $2,570.40 | Professional | 80 · Assistant surgeon | $363.08 | $1,288.25 | $2,570.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $1,122.02 Typical High $2,238.72 | Professional | AS · PA/NP assist | $316.23 | $1,122.02 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,011.87 Typical High $7,762.47 | Facility | None | $812.83 | $5,011.87 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $6,165.95 Typical High $10,715.19 | Professional | None | $3,388.44 | $6,165.95 | $10,715.19 |
DeanCare Setting Facility Modifier None Typical Low $2,137.96 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,137.96 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $4,168.69 Median $5,128.61 Typical High $6,918.31 | Professional | None | $4,168.69 | $5,128.61 | $6,918.31 |
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 $2,398.83 Median $7,079.46 Typical High $11,481.54 | Professional | None | $2,398.83 | $7,079.46 | $11,481.54 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $4,073.80 | Facility | None | $2,089.30 | $2,884.03 | $4,073.80 |
Network Health Setting Professional Modifier None Typical Low $2,818.38 Median $4,897.79 Typical High $6,606.93 | Professional | None | $2,818.38 | $4,897.79 | $6,606.93 |
Prevea360 Setting Facility Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $4,365.16 | Facility | None | $1,778.28 | $2,290.87 | $4,365.16 |
Quartz Setting Professional Modifier None Typical Low $2,187.76 Median $5,011.87 Typical High $8,912.51 | Professional | None | $2,187.76 | $5,011.87 | $8,912.51 |
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 $3,388.44 Median $3,388.44 Typical High $4,570.88 | Professional | None | $3,388.44 | $3,388.44 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
Security Health Setting Professional Modifier None Typical Low $9,549.93 Median $12,589.25 Typical High $14,454.40 | Professional | None | $9,549.93 | $12,589.25 | $14,454.40 |
The Alliance Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $2,187.76 Median $7,079.46 Typical High $10,964.78 | Professional | None | $2,187.76 | $7,079.46 | $10,964.78 |
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 $1,288.25 Median $1,288.25 Typical High $10,964.78 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $10,964.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $4,365.16 | Professional | 53 · Discontinued | $524.81 | $524.81 | $4,365.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $16,218.10 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $16,218.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $3,311.31 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $3,311.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $2,187.76 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $2,187.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $15,135.61 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $15,135.61 |
Where Wisconsin sits
The same service costs 7.0 times more in Alabama than in Delaware. 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
AL $20,601DE $2,932
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.