How much rates vary
Facilitymedian $9,333 · 10th to 90th $832 to $21,380Professionalmedian $11,220 · 10th to 90th $4,169 to $23,988
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 $4,168.69 Median $4,168.69 Typical High $14,454.40 | Facility | None | $4,168.69 | $4,168.69 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $39,810.72 | Professional | None | $4,168.69 | $4,168.69 | $39,810.72 |
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 $3,630.78 Median $13,182.57 Typical High $27,542.29 | Professional | None | $3,630.78 | $13,182.57 | $27,542.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $2,089.30 Typical High $4,073.80 | Professional | 80 · Assistant surgeon | $588.84 | $2,089.30 | $4,073.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $1,819.70 Typical High $3,548.13 | Professional | AS · PA/NP assist | $512.86 | $1,819.70 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $8,128.31 Typical High $12,589.25 | Facility | None | $758.58 | $8,128.31 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $10,000.00 Typical High $17,378.01 | Professional | None | $5,495.41 | $10,000.00 | $17,378.01 |
DeanCare Setting Facility Modifier None Typical Low $3,715.35 Median $7,943.28 Typical High $14,791.08 | Facility | None | $3,715.35 | $7,943.28 | $14,791.08 |
DeanCare Setting Professional Modifier None Typical Low $6,760.83 Median $8,317.64 Typical High $11,220.18 | Professional | None | $6,760.83 | $8,317.64 | $11,220.18 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,818.38 Typical High $18,197.01 | Facility | None | $436.52 | $2,818.38 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $4,168.69 Median $11,481.54 Typical High $18,620.87 | Professional | None | $4,168.69 | $11,481.54 | $18,620.87 |
Network Health Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Network Health Setting Professional Modifier None Typical Low $4,570.88 Median $7,943.28 Typical High $14,454.40 | Professional | None | $4,570.88 | $7,943.28 | $14,454.40 |
Prevea360 Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $7,079.46 | Facility | None | $2,884.03 | $3,715.35 | $7,079.46 |
Quartz Setting Professional Modifier None Typical Low $3,548.13 Median $7,413.10 Typical High $13,489.63 | Professional | None | $3,548.13 | $7,413.10 | $13,489.63 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $3,630.78 | Facility | None | $645.65 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,413.10 | Professional | None | $5,495.41 | $5,495.41 | $7,413.10 |
Security Health Setting Professional Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Professional | None | $16,595.87 | $16,595.87 | $16,595.87 |
Security Health Setting Professional Modifier None Typical Low $18,620.87 Median $21,877.62 Typical High $25,118.86 | Professional | None | $18,620.87 | $21,877.62 | $25,118.86 |
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 $3,890.45 Median $11,481.54 Typical High $17,782.79 | Professional | None | $3,890.45 | $11,481.54 | $17,782.79 |
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 $2,089.30 Median $2,089.30 Typical High $19,498.45 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $19,498.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $7,943.28 | Professional | 53 · Discontinued | $851.14 | $851.14 | $7,943.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $29,512.09 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $29,512.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $5,888.44 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $5,888.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $416.87 Typical High $3,981.07 | Professional | 56 · Pre-op care only | $416.87 | $416.87 | $3,981.07 |
Where Wisconsin sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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
$11,220
AK $13,490AR $1,820
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.