How much rates vary
Facilitymedian $8,511 · 10th to 90th $891 to $21,380Professionalmedian $5,012 · 10th to 90th $1,820 to $10,965
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 $1,819.70 Median $1,819.70 Typical High $14,454.40 | Facility | None | $1,819.70 | $1,819.70 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $14,454.40 | Professional | None | $1,819.70 | $1,819.70 | $14,454.40 |
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 $1,584.89 Median $5,623.41 Typical High $12,022.64 | Professional | None | $1,584.89 | $5,623.41 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $3,548.13 Typical High $7,079.46 | Professional | 62 · Two surgeons | $1,000.00 | $3,548.13 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $891.25 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $251.19 | $891.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $776.25 Typical High $1,584.89 | Professional | AS · PA/NP assist | $223.87 | $776.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,548.13 Typical High $5,495.41 | Facility | None | $812.83 | $3,548.13 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $4,365.16 Typical High $7,585.78 | Professional | None | $2,398.83 | $4,365.16 | $7,585.78 |
DeanCare Setting Facility Modifier None Typical Low $1,621.81 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,621.81 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,951.21 | $3,630.78 | $4,786.30 |
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 $5,011.87 Typical High $8,128.31 | Professional | None | $1,778.28 | $5,011.87 | $8,128.31 |
Network Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $2,884.03 | Facility | None | $2,041.74 | $2,089.30 | $2,884.03 |
Network Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $4,570.88 | Professional | None | $1,995.26 | $3,467.37 | $4,570.88 |
Prevea360 Setting Facility Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $3,019.95 | Facility | None | $1,258.93 | $1,737.80 | $3,019.95 |
Quartz Setting Professional Modifier None Typical Low $1,548.82 Median $3,548.13 Typical High $6,309.57 | Professional | None | $1,548.82 | $3,548.13 | $6,309.57 |
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 $2,398.83 Median $2,398.83 Typical High $3,235.94 | Professional | None | $2,398.83 | $2,398.83 | $3,235.94 |
Security Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
Security Health Setting Professional Modifier None Typical Low $6,606.93 Median $8,912.51 Typical High $10,000.00 | Professional | None | $6,606.93 | $8,912.51 | $10,000.00 |
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 $1,659.59 Median $5,011.87 Typical High $7,762.47 | Professional | None | $1,659.59 | $5,011.87 | $7,762.47 |
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 $912.01 Median $912.01 Typical High $7,244.36 | Professional | 52 · Reduced service | $912.01 | $912.01 | $7,244.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $2,884.03 | Professional | 53 · Discontinued | $371.54 | $371.54 | $2,884.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $10,964.78 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $2,187.76 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $2,187.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $1,445.44 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $1,445.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $10,232.93 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $10,232.93 |
Where Wisconsin sits
The same service costs 5.9 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
$5,370
AK $5,888TX $1,000
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.