How much rates vary
Facilitymedian $8,318 · 10th to 90th $891 to $18,197Professionalmedian $6,310 · 10th to 90th $2,291 to $14,791
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 $2,290.87 Median $2,290.87 Typical High $14,454.40 | Facility | None | $2,290.87 | $2,290.87 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $19,054.61 | Professional | None | $2,290.87 | $2,290.87 | $19,054.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $12,589.25 Typical High $19,952.62 | Facility | None | $10,000.00 | $12,589.25 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $7,079.46 Typical High $15,135.61 | Professional | None | $1,995.26 | $7,079.46 | $15,135.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $1,122.02 Typical High $2,398.83 | Professional | 80 · Assistant surgeon | $323.59 | $1,122.02 | $2,398.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $1,000.00 Typical High $2,089.30 | Professional | AS · PA/NP assist | $281.84 | $1,000.00 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,466.84 Typical High $6,918.31 | Facility | None | $812.83 | $4,466.84 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $5,495.41 Typical High $9,549.93 | Professional | None | $3,019.95 | $5,495.41 | $9,549.93 |
DeanCare Setting Facility Modifier None Typical Low $2,041.74 Median $7,943.28 Typical High $14,454.40 | Facility | None | $2,041.74 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $3,715.35 Median $4,570.88 Typical High $6,165.95 | Professional | None | $3,715.35 | $4,570.88 | $6,165.95 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $18,197.01 | Facility | None | $436.52 | $2,570.40 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $2,238.72 Median $6,309.57 Typical High $10,232.93 | Professional | None | $2,238.72 | $6,309.57 | $10,232.93 |
Network Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,801.89 | Facility | None | $2,089.30 | $2,570.40 | $3,801.89 |
Network Health Setting Professional Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $6,025.60 | Professional | None | $2,511.89 | $4,365.16 | $6,025.60 |
Prevea360 Setting Facility Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,890.45 | Facility | None | $1,584.89 | $2,187.76 | $3,890.45 |
Quartz Setting Professional Modifier None Typical Low $1,949.84 Median $4,466.84 Typical High $7,943.28 | Professional | None | $1,949.84 | $4,466.84 | $7,943.28 |
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 $3,019.95 Median $3,019.95 Typical High $4,073.80 | Professional | None | $3,019.95 | $3,019.95 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
Security Health Setting Professional Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,882.50 | Professional | None | $8,511.38 | $11,220.18 | $12,882.50 |
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 $2,089.30 Median $6,309.57 Typical High $9,772.37 | Professional | None | $2,089.30 | $6,309.57 | $9,772.37 |
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 $1,148.15 Median $1,148.15 Typical High $9,549.93 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $9,549.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $3,801.89 | Professional | 53 · Discontinued | $457.09 | $457.09 | $3,801.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $14,454.40 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $14,454.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $2,884.03 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $2,884.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $1,905.46 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $1,905.46 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $13,489.63 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $13,489.63 |
Where Wisconsin sits
The same service costs 6.3 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
$6,607
AK $7,413TX $1,175
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.