How much rates vary
Facilitymedian $8,511 · 10th to 90th $759 to $21,380Professionalmedian $2,455 · 10th to 90th $891 to $5,248
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 $912.01 Median $912.01 Typical High $14,454.40 | Facility | None | $912.01 | $912.01 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $7,585.78 | Professional | None | $912.01 | $912.01 | $7,585.78 |
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 $794.33 Median $2,818.38 Typical High $5,754.40 | Professional | None | $794.33 | $2,818.38 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $457.09 Typical High $912.01 | Professional | 80 · Assistant surgeon | $125.89 | $457.09 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $398.11 Typical High $794.33 | Professional | AS · PA/NP assist | $109.65 | $398.11 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $2,691.53 | Facility | None | $812.83 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,174.90 | $2,137.96 | $3,801.89 |
DeanCare Setting Facility Modifier None Typical Low $794.33 Median $7,943.28 Typical High $14,791.08 | Facility | None | $794.33 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,819.70 | $2,454.71 |
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 $954.99 Median $2,511.89 Typical High $4,073.80 | Professional | None | $954.99 | $2,511.89 | $4,073.80 |
Network Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,089.30 | Facility | None | $1,023.29 | $1,445.44 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,000.00 | $1,698.24 | $3,162.28 |
Prevea360 Setting Facility Modifier None Typical Low $616.60 Median $794.33 Typical High $1,548.82 | Facility | None | $616.60 | $794.33 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $758.58 Median $1,584.89 Typical High $2,951.21 | Professional | None | $758.58 | $1,584.89 | $2,951.21 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,691.53 | Facility | None | $758.58 | $1,023.29 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
Security Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Security Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,786.30 Typical High $5,495.41 | Professional | None | $3,981.07 | $4,786.30 | $5,495.41 |
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 $831.76 Median $2,511.89 Typical High $3,981.07 | Professional | None | $831.76 | $2,511.89 | $3,981.07 |
5 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 $457.09 Median $457.09 Typical High $3,801.89 | Professional | 52 · Reduced service | $457.09 | $457.09 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $1,513.56 | Professional | 53 · Discontinued | $181.97 | $181.97 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $5,623.41 | Professional | 54 · Surgery only | $676.08 | $676.08 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $1,122.02 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $758.58 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $758.58 |
Where Wisconsin sits
The same service costs 3.8 times more in Wisconsin than in New York. 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· 1st of 51
$2,951
WI $2,951NY $776
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.