How much rates vary
Facilitymedian $8,710 · 10th to 90th $891 to $21,380Professionalmedian $6,918 · 10th to 90th $2,512 to $15,488
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 $2,511.89 Median $2,511.89 Typical High $14,454.40 | Facility | None | $2,511.89 | $2,511.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $20,417.38 | Professional | None | $2,511.89 | $2,511.89 | $20,417.38 |
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 $2,187.76 Median $7,762.47 Typical High $16,595.87 | Professional | None | $2,187.76 | $7,762.47 | $16,595.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $1,258.93 Typical High $2,511.89 | Professional | 80 · Assistant surgeon | $354.81 | $1,258.93 | $2,511.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $1,096.48 Typical High $2,187.76 | Professional | AS · PA/NP assist | $309.03 | $1,096.48 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,897.79 Typical High $7,585.78 | Facility | None | $812.83 | $4,897.79 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $6,025.60 Typical High $10,471.29 | Professional | None | $3,311.31 | $6,025.60 | $10,471.29 |
DeanCare Setting Facility Modifier None Typical Low $2,238.72 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,238.72 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $4,073.80 Median $5,011.87 Typical High $6,760.83 | Professional | None | $4,073.80 | $5,011.87 | $6,760.83 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,511.89 Typical High $18,197.01 | Facility | None | $436.52 | $2,511.89 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,511.89 Median $6,918.31 Typical High $11,220.18 | Professional | None | $2,511.89 | $6,918.31 | $11,220.18 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $4,168.69 | Facility | None | $2,089.30 | $2,818.38 | $4,168.69 |
Network Health Setting Professional Modifier None Typical Low $2,754.23 Median $4,786.30 Typical High $6,456.54 | Professional | None | $2,754.23 | $4,786.30 | $6,456.54 |
Prevea360 Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $4,265.80 | Facility | None | $1,737.80 | $2,398.83 | $4,265.80 |
Quartz Setting Professional Modifier None Typical Low $2,137.96 Median $4,897.79 Typical High $8,709.64 | Professional | None | $2,137.96 | $4,897.79 | $8,709.64 |
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 $3,311.31 Median $3,311.31 Typical High $4,570.88 | Professional | None | $3,311.31 | $3,311.31 | $4,570.88 |
Security Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Security Health Setting Professional Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $14,125.38 | Professional | None | $9,332.54 | $12,302.69 | $14,125.38 |
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 $2,290.87 Median $6,918.31 Typical High $10,964.78 | Professional | None | $2,290.87 | $6,918.31 | $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 $1,258.93 Median $1,258.93 Typical High $10,232.93 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $10,232.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $4,073.80 | Professional | 53 · Discontinued | $512.86 | $512.86 | $4,073.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $15,488.17 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $15,488.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $3,090.30 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $3,090.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $2,041.74 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $2,041.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $14,454.40 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $14,454.40 |
Where Wisconsin sits
The same service costs 5.2 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
$7,244
AK $8,128TX $1,549
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.