How much rates vary
Facilitymedian $8,710 · 10th to 90th $891 to $21,380Professionalmedian $8,913 · 10th to 90th $3,236 to $19,953
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 $3,311.31 Median $3,311.31 Typical High $14,454.40 | Facility | None | $3,311.31 | $3,311.31 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $27,542.29 | Professional | None | $3,311.31 | $3,311.31 | $27,542.29 |
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 $2,818.38 Median $9,772.37 Typical High $20,417.38 | Professional | None | $2,818.38 | $9,772.37 | $20,417.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $1,584.89 Typical High $3,235.94 | Professional | 80 · Assistant surgeon | $446.68 | $1,584.89 | $3,235.94 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $1,380.38 Typical High $2,818.38 | Professional | AS · PA/NP assist | $389.05 | $1,380.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,309.57 Typical High $9,772.37 | Facility | None | $812.83 | $6,309.57 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $4,265.80 Median $7,762.47 Typical High $13,489.63 | Professional | None | $4,265.80 | $7,762.47 | $13,489.63 |
DeanCare Setting Facility Modifier None Typical Low $2,884.03 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,884.03 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $5,248.07 Median $6,456.54 Typical High $8,709.64 | Professional | None | $5,248.07 | $6,456.54 | $8,709.64 |
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 $3,235.94 Median $8,912.51 Typical High $14,454.40 | Professional | None | $3,235.94 | $8,912.51 | $14,454.40 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $5,128.61 | Facility | None | $2,089.30 | $3,630.78 | $5,128.61 |
Network Health Setting Professional Modifier None Typical Low $3,548.13 Median $6,165.95 Typical High $8,317.64 | Professional | None | $3,548.13 | $6,165.95 | $8,317.64 |
Prevea360 Setting Facility Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $5,495.41 | Facility | None | $2,238.72 | $3,090.30 | $5,495.41 |
Quartz Setting Professional Modifier None Typical Low $2,754.23 Median $6,309.57 Typical High $11,220.18 | Professional | None | $2,754.23 | $6,309.57 | $11,220.18 |
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 $4,265.80 Median $4,265.80 Typical High $5,754.40 | Professional | None | $4,265.80 | $4,265.80 | $5,754.40 |
Security Health Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Professional | None | $12,882.50 | $12,882.50 | $12,882.50 |
Security Health Setting Professional Modifier None Typical Low $12,022.64 Median $15,848.93 Typical High $18,197.01 | Professional | None | $12,022.64 | $15,848.93 | $18,197.01 |
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 $2,951.21 Median $8,912.51 Typical High $13,803.84 | Professional | None | $2,951.21 | $8,912.51 | $13,803.84 |
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 $1,621.81 Median $1,621.81 Typical High $13,803.84 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $13,803.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $5,495.41 | Professional | 53 · Discontinued | $660.69 | $660.69 | $5,495.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,454.71 Typical High $20,892.96 | Professional | 54 · Surgery only | $2,454.71 | $2,454.71 | $20,892.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $4,168.69 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $4,168.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $2,754.23 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $2,754.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,290.87 Typical High $19,498.45 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,290.87 | $19,498.45 |
Where Wisconsin sits
The same service costs 9.8 times more in Alabama than in Maryland. 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 $35,171MD $3,582
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.